Provider Demographics
NPI:1851167928
Name:GUADALUPE, ARIANNA NOEMI (MAESTRIA)
Entity Type:Individual
Prefix:MRS
First Name:ARIANNA
Middle Name:NOEMI
Last Name:GUADALUPE
Suffix:
Gender:F
Credentials:MAESTRIA
Other - Prefix:MRS
Other - First Name:ARIANNA
Other - Middle Name:GUADALUPE
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAESTRIA
Mailing Address - Street 1:CONDOMINIO PASEO ESMERALDA
Mailing Address - Street 2:112 CALLE 21 APT 12102
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-486-3200
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO PASEO ESMERALDA
Practice Address - Street 2:112 CALLE 21 APT 12102
Practice Address - City:FAJARDO
Practice Address - State:RI
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-486-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR143001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical