Provider Demographics
NPI:1649855669
Name:DEL VALLE RODRIGUEZ, MARIA ISABEL
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ISABEL
Last Name:DEL VALLE RODRIGUEZ
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:URB. REINA DE LOS ANGELES
Mailing Address - Street 2:CALLE 9, D-10
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-972-5669
Mailing Address - Fax:
Practice Address - Street 1:PR-1 AVE. SAKURA BAIROA INDUSTRIAL PARK
Practice Address - Street 2:OFICINA 235-A
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-669-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6765103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling