Provider Demographics
NPI:1326340811
Name:MOLINA, MARITZA (MRC)
Entity Type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:MRC
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 1170
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-1170
Mailing Address - Country:US
Mailing Address - Phone:787-385-4533
Mailing Address - Fax:787-879-9183
Practice Address - Street 1:1 AVE JUPITER
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3216
Practice Address - Country:US
Practice Address - Phone:787-880-4058
Practice Address - Fax:787-879-9183
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR668225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor