Provider Demographics
NPI:1184323107
Name:DIEPPA, ROSIRIS DEL MAR
Entity type:Individual
Prefix:
First Name:ROSIRIS
Middle Name:DEL MAR
Last Name:DIEPPA
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:URB BOSQUES DE LA SIERRA
Mailing Address - Street 2:COQUI MELODIOSO 528
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-605-0767
Mailing Address - Fax:
Practice Address - Street 1:Q12 AVE CHUMLEY
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-6063
Practice Address - Country:US
Practice Address - Phone:787-364-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001262235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist