Provider Demographics
NPI:1023858941
Name:PIMENTEL ROHENA, MARICARMEN
Entity type:Individual
Prefix:
First Name:MARICARMEN
Middle Name:
Last Name:PIMENTEL ROHENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARICARMEN
Other - Middle Name:
Other - Last Name:PIMENTEL ROHENA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 1216
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-1216
Mailing Address - Country:US
Mailing Address - Phone:787-641-1985
Mailing Address - Fax:
Practice Address - Street 1:57A C3
Practice Address - Street 2:CIENAGA BAJA
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-641-1985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4137101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional