Provider Demographics
NPI:1093212649
Name:DELGADO, DUNECHKA (OTL)
Entity Type:Individual
Prefix:
First Name:DUNECHKA
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H31 CALLE AMAPOLA
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3345
Mailing Address - Country:US
Mailing Address - Phone:787-439-8894
Mailing Address - Fax:
Practice Address - Street 1:55 CALLE A
Practice Address - Street 2:URB. JARDINES DE ARECIBO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3345
Practice Address - Country:US
Practice Address - Phone:787-439-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0819225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty