Provider Demographics
NPI:1841094307
Name:BURGOS, VERONICA (MPSY)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:BURGOS
Suffix:
Gender:
Credentials:MPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 CALLE GRAU
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3154
Mailing Address - Country:US
Mailing Address - Phone:939-777-9512
Mailing Address - Fax:
Practice Address - Street 1:5 CARR 798 KM 0.5 BO. RIO CANAS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:939-777-9512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7320103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty