Provider Demographics
NPI:1841737400
Name:CARTAGENA, ROSALY (PSYD, LND)
Entity Type:Individual
Prefix:MS
First Name:ROSALY
Middle Name:
Last Name:CARTAGENA
Suffix:
Gender:F
Credentials:PSYD, LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AG1 CALLE SONORA
Mailing Address - Street 2:URB VENUS GARDEN NORTE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4693
Mailing Address - Country:US
Mailing Address - Phone:787-513-8413
Mailing Address - Fax:
Practice Address - Street 1:AG1 CALLE SONORA
Practice Address - Street 2:URB VENUS GARDEN NORTE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4693
Practice Address - Country:US
Practice Address - Phone:787-513-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3863103T00000X
PR1343133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No133N00000XDietary & Nutritional Service ProvidersNutritionist