Provider Demographics
NPI:1518985738
Name:GRAU MAGAT, MARITZA (MSW, ACSW)
Entity type:Individual
Prefix:MS
First Name:MARITZA
Middle Name:
Last Name:GRAU MAGAT
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CALLE HORTENSIA
Mailing Address - Street 2:3C CONDOMINIO SKY TOWER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE HORTENSIA
Practice Address - Street 2:3C
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6439
Practice Address - Country:US
Practice Address - Phone:787-541-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5202OtherSW LIC.