Provider Demographics
NPI:1649516444
Name:LIQUET, MINOSHKA DENISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MINOSHKA
Middle Name:DENISE
Last Name:LIQUET
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:T20 CALLE PINO
Mailing Address - Street 2:VALLE HERMOSO
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-1413
Mailing Address - Country:US
Mailing Address - Phone:787-458-7225
Mailing Address - Fax:
Practice Address - Street 1:T20 CALLE PINO
Practice Address - Street 2:VALLE HERMOSO
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660-1413
Practice Address - Country:US
Practice Address - Phone:787-458-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4558103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical