Provider Demographics
NPI:1720318470
Name:BERRIOS, MARIA M (CPL)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:M
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:CPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 6606
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-9519
Mailing Address - Country:US
Mailing Address - Phone:787-314-2733
Mailing Address - Fax:787-735-3233
Practice Address - Street 1:CARRETERA ESTATAL 14 INTERIOR
Practice Address - Street 2:CALLE SARGENTO GERARDO SANTIAGO
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-1379
Practice Address - Country:US
Practice Address - Phone:787-714-2466
Practice Address - Fax:787-735-3233
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2562101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional