Provider Demographics
NPI:1528187283
Name:HECHAVARRIA, ROSA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:M
Last Name:HECHAVARRIA
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 1:78 CALLE CORALINA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9634
Mailing Address - Country:US
Mailing Address - Phone:787-758-2500
Mailing Address - Fax:787-751-9625
Practice Address - Street 1:464 CALLE JOSEFA MENDIA
Practice Address - Street 2:LOS MAESTROS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-2413
Practice Address - Country:US
Practice Address - Phone:939-649-4893
Practice Address - Fax:787-731-8780
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1674103TC0700X, 103TE1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports