Provider Demographics
NPI:1205542339
Name:SALGADO RODRIGUEZ, ANGEL DAVID (MA)
Entity type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:DAVID
Last Name:SALGADO RODRIGUEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 69 112
Mailing Address - Street 2:BARRIO GUARAGUAO ABAJO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:787-454-0203
Mailing Address - Fax:
Practice Address - Street 1:CARR 174 KM0 H0
Practice Address - Street 2:BARRIO GUARAGUAO ABAJO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-454-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7622103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling