Provider Demographics
NPI:1518258839
Name:ROMERO, MARYURY (MA)
Entity Type:Individual
Prefix:
First Name:MARYURY
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MARYURY
Other - Middle Name:
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1666 CALLE PARANA
Mailing Address - Street 2:URB. EL CEREZAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3628
Mailing Address - Country:US
Mailing Address - Phone:787-297-7340
Mailing Address - Fax:
Practice Address - Street 1:139 CALLE ALICANTE
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3628
Practice Address - Country:US
Practice Address - Phone:787-297-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3950103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling