Provider Demographics
NPI:1003038308
Name:GIROD SOLIVAN, AIDA N (PSYD)
Entity type:Individual
Prefix:DR
First Name:AIDA
Middle Name:N
Last Name:GIROD SOLIVAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:AIDA
Other - Middle Name:
Other - Last Name:GIROD SOLIVAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:2050 CARR.8177
Mailing Address - Street 2:APTO.501
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-605-0114
Mailing Address - Fax:787-731-3275
Practice Address - Street 1:2050 CARR.8177
Practice Address - Street 2:APTO.501
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-605-0114
Practice Address - Fax:787-731-3275
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR68103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical