Provider Demographics
NPI:1629202098
Name:PINEIRO, GRETZA M (PSY D)
Entity Type:Individual
Prefix:
First Name:GRETZA
Middle Name:M
Last Name:PINEIRO
Suffix:
Gender:F
Credentials:PSY D
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 199
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-0199
Mailing Address - Country:US
Mailing Address - Phone:787-415-6249
Mailing Address - Fax:
Practice Address - Street 1:D12 CALLE MIS AMORES
Practice Address - Street 2:URB. SAN ALFONSO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5821
Practice Address - Country:US
Practice Address - Phone:787-930-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical