Provider Demographics
NPI:1245473305
Name:OCASIO CEDENO, MARILYN (PSY D)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:OCASIO CEDENO
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LA GUADALUPE
Mailing Address - Street 2:CALLE LA MILAGROSA 1908
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-813-9537
Mailing Address - Fax:
Practice Address - Street 1:70 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-1635
Practice Address - Country:US
Practice Address - Phone:787-901-1825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-19
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR91761041C0700X
PR6530103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6530OtherLICENCIA