Provider Demographics
NPI:1629379698
Name:VILLENEUVE, MARIA LEONOR (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LEONOR
Last Name:VILLENEUVE
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 1:159 CALLE COSTA RICA
Mailing Address - Street 2:APT. 14E COND. AVILA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-2510
Mailing Address - Country:US
Mailing Address - Phone:787-754-1941
Mailing Address - Fax:
Practice Address - Street 1:159 CALLE COSTA RICA
Practice Address - Street 2:APT. 14E COND. AVILA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-2510
Practice Address - Country:US
Practice Address - Phone:787-754-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001355103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist