Provider Demographics
NPI:1023595360
Name:SIFRES NEGRON, JOAN MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARIE
Last Name:SIFRES NEGRON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 581
Mailing Address - Street 2:
Mailing Address - City:NAGUABO
Mailing Address - State:PR
Mailing Address - Zip Code:00718
Mailing Address - Country:US
Mailing Address - Phone:787-312-4266
Mailing Address - Fax:
Practice Address - Street 1:CARR 969 KM 6.5
Practice Address - Street 2:BO MAIZALES
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718
Practice Address - Country:US
Practice Address - Phone:787-312-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist