Provider Demographics
NPI:1952734857
Name:GUADALUPE, SHEILA M
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:M
Last Name:GUADALUPE
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 1:37 CALLE TALLABOA
Mailing Address - Street 2:URB RIVER VALLEY PK
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-9605
Mailing Address - Country:US
Mailing Address - Phone:787-517-5317
Mailing Address - Fax:
Practice Address - Street 1:37 CALLE TALLABOA
Practice Address - Street 2:URB RIVER VALLEY PK
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-9605
Practice Address - Country:US
Practice Address - Phone:787-517-5317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4552103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist