Provider Demographics
NPI:1609016500
Name:LEBRON ROSA, MILITZA (PHD)
Entity Type:Individual
Prefix:MRS
First Name:MILITZA
Middle Name:
Last Name:LEBRON ROSA
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:URB. LOS ADOQUINES
Mailing Address - Street 2:# 41 CALLE SAN JUSTO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7356
Mailing Address - Country:US
Mailing Address - Phone:787-312-1702
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO FIRST FEDERAL SAVING BANK
Practice Address - Street 2:SUITE 608 AVE. MUNOZ RIVERA
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-312-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3249103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling