Provider Demographics
NPI:1922705714
Name:OQUENDO, EMILIE (MS, LP)
Entity Type:Individual
Prefix:
First Name:EMILIE
Middle Name:
Last Name:OQUENDO
Suffix:
Gender:F
Credentials:MS, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:F9 CALLE 9
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-2663
Mailing Address - Country:US
Mailing Address - Phone:939-745-2689
Mailing Address - Fax:
Practice Address - Street 1:1101 CALLE 6 NE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2512
Practice Address - Country:US
Practice Address - Phone:939-745-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7585103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling