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NPI Code Detail

MEDICARE: BRENDA MICHELLE ANGLADA RIVERA

MEDICARE:   BRENDA MICHELLE ANGLADA RIVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist6958PR

General Provider Information

NPI Number : 1003589425
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA MICHELLE ANGLADA RIVERA
Provider Business Mailing Address
First Line : PO BOX 386
Second Line :
City : SANTA ISABEL
State : PR
Zip : 00757-0386
Country : US
Telephone Number : 787-319-2659
Fax Number :
Provider Business Practice Location Address
First Line : 65 CALLE BALDORIOTY
Second Line :
City : COAMO
State : PR
Zip : 00769-2344
Country : US
Telephone Number : 787-614-3205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2021
Last Update Date : 09/13/2024

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Directions to “ BRENDA MICHELLE ANGLADA RIVERA ” Practice Location

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