Provider Demographics
NPI:1528540861
Name:RODRIGUEZ PALERMO, ELSIE MARIA (PSYD, MA)
Entity Type:Individual
Prefix:MRS
First Name:ELSIE
Middle Name:MARIA
Last Name:RODRIGUEZ PALERMO
Suffix:
Gender:F
Credentials:PSYD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0043
Mailing Address - Country:US
Mailing Address - Phone:787-610-5821
Mailing Address - Fax:
Practice Address - Street 1:445 GONZALEZ CLEMENTE AVE
Practice Address - Street 2:VAL HARBOUR PLAZA SUITE 301
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-610-5821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5990103TC1900X, 103TC0700X
PR103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty