Provider Demographics
NPI:1629869474
Name:VERA, ENID
Entity type:Individual
Prefix:
First Name:ENID
Middle Name:
Last Name:VERA
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 1:13 URB LOS MIRASOLES
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3212
Mailing Address - Country:US
Mailing Address - Phone:787-234-8718
Mailing Address - Fax:787-234-8718
Practice Address - Street 1:13 URB LOS MIRASOLES
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3212
Practice Address - Country:US
Practice Address - Phone:787-234-8718
Practice Address - Fax:787-234-8718
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4766103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist