Provider Demographics
NPI:1093957839
Name:LEBRON, MARIA I (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:I
Last Name:LEBRON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 7162
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-9783
Mailing Address - Country:US
Mailing Address - Phone:787-448-2543
Mailing Address - Fax:
Practice Address - Street 1:68 CALLE AQUAMARINA
Practice Address - Street 2:URB VILLA BLANCA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-1908
Practice Address - Country:US
Practice Address - Phone:787-744-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2864103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical