Provider Demographics
NPI:1508067844
Name:VELEZ, MARITZA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARITZA
Middle Name:
Last Name:VELEZ
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 1:30 CALLE NUEVA
Mailing Address - Street 2:BO. ANCONES
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4244
Mailing Address - Country:US
Mailing Address - Phone:787-210-5577
Mailing Address - Fax:
Practice Address - Street 1:30 CALLE NUEVA
Practice Address - Street 2:BO. ANCONES
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4244
Practice Address - Country:US
Practice Address - Phone:787-210-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002375103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical