Provider Demographics
NPI:1124371679
Name:CHARLEMAN-MORENO, ROSAURA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROSAURA
Middle Name:
Last Name:CHARLEMAN-MORENO
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 1:38 CALLE VENUS
Mailing Address - Street 2:URB. EL VERDE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-6340
Mailing Address - Country:US
Mailing Address - Phone:787-725-6500
Mailing Address - Fax:
Practice Address - Street 1:38 CALLE VENUS
Practice Address - Street 2:URB. EL VERDE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6340
Practice Address - Country:US
Practice Address - Phone:787-725-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1775103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical