Provider Demographics
NPI:1205202199
Name:LOPEZ-RAMIREZ, ROSAYMA
Entity Type:Individual
Prefix:
First Name:ROSAYMA
Middle Name:
Last Name:LOPEZ-RAMIREZ
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 33092
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00933-3092
Mailing Address - Country:US
Mailing Address - Phone:787-789-3481
Mailing Address - Fax:
Practice Address - Street 1:134 CALLE MORADILLA
Practice Address - Street 2:URB. MILAVILLE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5123
Practice Address - Country:US
Practice Address - Phone:787-929-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3252103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist