Provider Demographics
NPI:1922370758
Name:RODRIGUEZ-CABRERA, VENUS IVETTE (MS)
Entity Type:Individual
Prefix:MS
First Name:VENUS
Middle Name:IVETTE
Last Name:RODRIGUEZ-CABRERA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PRIMAVERA, EL CONDOMINIO CARRETERA 2
Mailing Address - Street 2:2340 APARTADO 63
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-4803
Mailing Address - Country:US
Mailing Address - Phone:787-479-0728
Mailing Address - Fax:
Practice Address - Street 1:PRIMAVERA, EL COND. CARR. 2 2340 APT. 63
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4803
Practice Address - Country:US
Practice Address - Phone:787-479-0728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1692103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist