Provider Demographics
NPI:1134491566
Name:GARCIA-BERRIOS, ROSA ENID (PH D)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:ENID
Last Name:GARCIA-BERRIOS
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:F5 CALLE 2
Mailing Address - Street 2:URB. LOS ROSALES
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3107
Mailing Address - Country:US
Mailing Address - Phone:787-852-9864
Mailing Address - Fax:
Practice Address - Street 1:A-17 CALLE 2
Practice Address - Street 2:URB. VILLA UNIVERSITARIA
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-649-4334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2061103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist