Provider Demographics
NPI:1760795157
Name:LOPEZ ROBLEDO, YARITZA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:YARITZA
Middle Name:M
Last Name:LOPEZ ROBLEDO
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 1:161 CALLE FLAMBOYANES
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2811
Mailing Address - Country:US
Mailing Address - Phone:787-202-2144
Mailing Address - Fax:
Practice Address - Street 1:161 CALLE FLAMBOYANES
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2811
Practice Address - Country:US
Practice Address - Phone:787-202-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3709103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical