Provider Demographics
NPI:1710243944
Name:RODRIGUEZ, DIANA MARIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:MARIA
Last Name:RODRIGUEZ
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Gender:F
Credentials:PSYD
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Mailing Address - Street 1:201 CALLE GAUTIER BENITEZ
Mailing Address - Street 2:CONSOLIDATED MEDICAL PLAZA SUITE 012
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5527
Mailing Address - Country:US
Mailing Address - Phone:787-961-3600
Mailing Address - Fax:787-961-3601
Practice Address - Street 1:EDIFICIO A PORRATA PILA SUITE 205
Practice Address - Street 2:2431 BLVD LUIS A FERRE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2113
Practice Address - Country:US
Practice Address - Phone:787-848-5050
Practice Address - Fax:787-848-5175
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2020-05-12
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Provider Licenses
StateLicense IDTaxonomies
PR4187103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical