Provider Demographics
NPI:1649328733
Name:WARD, MARIA REBECCA (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:REBECCA
Last Name:WARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:46 SANTA ANASTACIA ST.
Mailing Address - Street 2:EL VIGIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-751-4391
Mailing Address - Fax:787-751-4391
Practice Address - Street 1:46 SANTA ANASTACIA ST.
Practice Address - Street 2:EL VIGIA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-751-4391
Practice Address - Fax:787-751-4391
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1107-PY-PR-TEMP103TC0700X
NJNJDCATEMP-030062103TC0700X
PR1257103T00000X, 103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent