Provider Demographics
NPI:1174849145
Name:CARTAGENA VAZQUEZ, ROSA E
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:E
Last Name:CARTAGENA VAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ROSA
Other - Middle Name:E
Other - Last Name:CARTAGENA VAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 CALLE 1
Mailing Address - Street 2:URB JARDINES DE TOA ALTA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-1832
Mailing Address - Country:US
Mailing Address - Phone:787-630-4373
Mailing Address - Fax:
Practice Address - Street 1:26 CALLE 1
Practice Address - Street 2:URB JARDINES DE TOA ALTA
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-1832
Practice Address - Country:US
Practice Address - Phone:787-630-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3199103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical