Provider Demographics
NPI:1821882242
Name:FAUSTINELLI, FLAVIA ANTONELLA (MS)
Entity type:Individual
Prefix:
First Name:FLAVIA
Middle Name:ANTONELLA
Last Name:FAUSTINELLI
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-0564
Mailing Address - Country:US
Mailing Address - Phone:939-489-0568
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 564
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-0564
Practice Address - Country:US
Practice Address - Phone:939-489-0568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7793103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist