Provider Demographics
NPI:1952717266
Name:RODRIGUEZ FELICIANO, EMMA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:J
Last Name:RODRIGUEZ FELICIANO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 AVE MUNOZ RIVERA
Mailing Address - Street 2:REPARTO UNIVERSITARIO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0639
Mailing Address - Country:US
Mailing Address - Phone:787-209-0124
Mailing Address - Fax:
Practice Address - Street 1:1224 AVE MUNOZ RIVERA
Practice Address - Street 2:REPARTO UNIVERSITARIO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0639
Practice Address - Country:US
Practice Address - Phone:787-209-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5319103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical