Provider Demographics
NPI:1184840498
Name:RODRIGUEZ, TANIA DEL MAR (PHD)
Entity Type:Individual
Prefix:DR
First Name:TANIA
Middle Name:DEL MAR
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
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 643
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-0643
Mailing Address - Country:US
Mailing Address - Phone:787-806-2220
Mailing Address - Fax:787-806-2220
Practice Address - Street 1:CALLE MENDEZ VIGO 63 ESTE
Practice Address - Street 2:EDIFICIO CENTRO PLAZA, OFICINA 4A
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4968
Practice Address - Country:US
Practice Address - Phone:787-806-2220
Practice Address - Fax:787-806-2220
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2441103TC1900X
FLPY11950103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling