Provider Demographics
NPI:1407843600
Name:ACEVEDO, MARIA M (PHD)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:M
Last Name:ACEVEDO
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:CHALETS DEL PARQUE #153
Mailing Address - Street 2:PARQUE DE LO NINOS 12
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5501
Mailing Address - Country:US
Mailing Address - Phone:787-789-6828
Mailing Address - Fax:
Practice Address - Street 1:818 AVE ITURREGUI
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-1723
Practice Address - Country:US
Practice Address - Phone:787-768-0390
Practice Address - Fax:787-768-1775
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1246103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical