Provider Demographics
NPI:1922888395
Name:HERNANDEZ BARRETO, NELMARIS (PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:NELMARIS
Middle Name:
Last Name:HERNANDEZ BARRETO
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 61072
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9074
Mailing Address - Country:US
Mailing Address - Phone:737-386-5307
Mailing Address - Fax:
Practice Address - Street 1:MOCA MEDICAL PLAZA 318-328 CALLE JOSE C BARBOSA
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:737-386-5307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7360103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling