Provider Demographics
NPI:1265702708
Name:ROMAN-PAGAN, ARELIS JANET (MA)
Entity type:Individual
Prefix:
First Name:ARELIS
Middle Name:JANET
Last Name:ROMAN-PAGAN
Suffix:
Gender:F
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:PO BOX 283
Mailing Address - Street 2:
Mailing Address - City:SABANA HOYOS
Mailing Address - State:PR
Mailing Address - Zip Code:00688-0283
Mailing Address - Country:US
Mailing Address - Phone:787-344-8352
Mailing Address - Fax:
Practice Address - Street 1:BARRIO SABANA HOYOS SECTOR CAROLINA
Practice Address - Street 2:CARR 2 R 639 KM 6.0
Practice Address - City:SABANA HOYOS
Practice Address - State:PR
Practice Address - Zip Code:00688
Practice Address - Country:US
Practice Address - Phone:787-344-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4195103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4195OtherLICENCIA DE PSICOLOGA