Provider Demographics
NPI:1790828374
Name:GONZA1EZ ROBLES, EMMA (MA)
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:
Last Name:GONZA1EZ ROBLES
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 1:629 CALLE HOOVER
Mailing Address - Street 2:LA CUMBRE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5621
Mailing Address - Country:US
Mailing Address - Phone:787-531-6770
Mailing Address - Fax:
Practice Address - Street 1:629 CALLE HOOVER
Practice Address - Street 2:LA CUMBRE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5621
Practice Address - Country:US
Practice Address - Phone:787-531-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR072103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist