Provider Demographics
NPI:1942734769
Name:BON ABREU, CRISTINA MARIE
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:BON ABREU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 AVE A
Mailing Address - Street 2:APT 101
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-7332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 AVE A
Practice Address - Street 2:APT 101
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-7332
Practice Address - Country:US
Practice Address - Phone:787-390-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5767103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical