Provider Demographics
NPI:1356795603
Name:ROBLES, WALESCA (MA)
Entity type:Individual
Prefix:
First Name:WALESCA
Middle Name:
Last Name:ROBLES
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:CALLE AZUCENA 157
Mailing Address - Street 2:CIUDAD JARDIN
Mailing Address - City:CAROLINA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00987
Mailing Address - Country:UM
Mailing Address - Phone:787-462-5685
Mailing Address - Fax:
Practice Address - Street 1:CALLE AZUCENA 157
Practice Address - Street 2:CIUDAD JARDIN
Practice Address - City:CAROLINA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00987
Practice Address - Country:UM
Practice Address - Phone:787-462-5685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical