Provider Demographics
NPI:1033252358
Name:MEDINA, DEBORAH ABRIL (MASTER D)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ABRIL
Last Name:MEDINA
Suffix:
Gender:F
Credentials:MASTER D
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:ABRIL
Other - Last Name:OLARTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MASTER D,
Mailing Address - Street 1:1312 FELIX ALDARONDO AVE.
Mailing Address - Street 2:PMB 487
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-872-1717
Mailing Address - Fax:787-872-1717
Practice Address - Street 1:CARR. #2 EDIFICIO PROFESSIONAL PLAZA
Practice Address - Street 2:SUITE 203
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-872-1717
Practice Address - Fax:787-872-1717
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2018103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist