Provider Demographics
NPI:1902821408
Name:RODRIGUEZ NIELSEN, GABRIELA M (PHD)
Entity Type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:M
Last Name:RODRIGUEZ NIELSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 71474
Mailing Address - Street 2:APS PROVEEDORES
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8574
Mailing Address - Country:US
Mailing Address - Phone:787-641-0774
Mailing Address - Fax:787-641-0776
Practice Address - Street 1:FERNANDEZ JUNCOS CAROLINA MEDICAL PLAZA A-1
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:787-641-0776
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR2358103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist