Provider Demographics
NPI:1013583442
Name:TIRADO, FRANCHESKA RACHELLE
Entity Type:Individual
Prefix:DR
First Name:FRANCHESKA
Middle Name:RACHELLE
Last Name:TIRADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2652
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-2652
Mailing Address - Country:US
Mailing Address - Phone:754-444-8038
Mailing Address - Fax:
Practice Address - Street 1:VILLAS DEL DEPORTIVO APT 106P
Practice Address - Street 2:
Practice Address - City:CABO ROJOS
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:754-444-8038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6921103TS0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6921OtherNONE