Provider Demographics
NPI:1194377531
Name:JUSTINIANO ROSARIO, SHEILA JOAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:JOAN
Last Name:JUSTINIANO ROSARIO
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 1:223 HORMIGUEROS APARTMENTS
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660
Mailing Address - Country:US
Mailing Address - Phone:787-217-2414
Mailing Address - Fax:
Practice Address - Street 1:740 AVE HOSTOS STE 308
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1541
Practice Address - Country:US
Practice Address - Phone:787-217-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2020-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6373103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical