Provider Demographics
NPI:1710562160
Name:MALDONADO VARELA, EVA HAYDEE (PSY D)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:HAYDEE
Last Name:MALDONADO VARELA
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 381
Mailing Address - Street 2:
Mailing Address - City:SABANA HOYOS
Mailing Address - State:PR
Mailing Address - Zip Code:00688-0381
Mailing Address - Country:US
Mailing Address - Phone:939-262-5841
Mailing Address - Fax:
Practice Address - Street 1:CARR. 628 KM 4.4
Practice Address - Street 2:SABANA HOYOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00688
Practice Address - Country:US
Practice Address - Phone:939-262-5841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6818103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical