Provider Demographics
NPI:1649598814
Name:ROLON RODRIGUEZ, TERESA
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:ROLON RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CALLE FARO
Mailing Address - Street 2:URBANIZACION BRISAS DE MAR CHIQUITA
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-9423
Mailing Address - Country:US
Mailing Address - Phone:787-384-4217
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 15271
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-9805
Practice Address - Country:US
Practice Address - Phone:787-222-1891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR76171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical