Provider Demographics
NPI:1164651436
Name:BADILLO, ARELYS
Entity Type:Individual
Prefix:MRS
First Name:ARELYS
Middle Name:
Last Name:BADILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1701
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1701
Mailing Address - Country:US
Mailing Address - Phone:787-349-8387
Mailing Address - Fax:
Practice Address - Street 1:WINNERS MALL CARRETERA 111 INTERSECCION CALAZAN LASALLE
Practice Address - Street 2:LOCAL F
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-349-8387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist