Provider Demographics
NPI:1497493738
Name:ROSARIO NEGRON, LAURA NOEMI (LCDA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:NOEMI
Last Name:ROSARIO NEGRON
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 3 CASA C-4
Mailing Address - Street 2:URB. VILLA AIDA
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-538-7999
Mailing Address - Fax:
Practice Address - Street 1:183 AVE UNIV INTERAMERICANA
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4455
Practice Address - Country:US
Practice Address - Phone:787-538-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7067103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist