Provider Demographics
NPI:1639316474
Name:TOLEDO, REBECA M (MA)
Entity Type:Individual
Prefix:MRS
First Name:REBECA
Middle Name:M
Last Name:TOLEDO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. NUM 2, KM. 96.8, BO. COCOS
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00678
Mailing Address - Country:UM
Mailing Address - Phone:787-895-1111
Mailing Address - Fax:
Practice Address - Street 1:CARR. # 2 KM. 96.8 BO. COCOS
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-895-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3170103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool