Provider Demographics
NPI:1427379502
Name:LARREGOITY-PADRO, PRINTZEL V (PSYD)
Entity Type:Individual
Prefix:
First Name:PRINTZEL
Middle Name:V
Last Name:LARREGOITY-PADRO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 AVE MUNOZ RIVERA
Mailing Address - Street 2:URB VILLA GRILLASCA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0635
Mailing Address - Country:US
Mailing Address - Phone:787-840-8545
Mailing Address - Fax:787-840-8545
Practice Address - Street 1:1121 AVE MUNOZ RIVERA
Practice Address - Street 2:URB VILLA GRILLASCA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0635
Practice Address - Country:US
Practice Address - Phone:787-840-8545
Practice Address - Fax:787-840-8545
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-12
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3248103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical