Healthcare Provider Details

I. General information

NPI: 1649692120
Provider Name (Legal Business Name): ANNETTE MARIE BARBOSA PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 AVE BORINQUEN
ARECIBO PR
00612-4490
US

IV. Provider business mailing address

PO BOX 143623
ARECIBO PR
00614-3623
US

V. Phone/Fax

Practice location:
  • Phone: 787-669-8333
  • Fax:
Mailing address:
  • Phone: 787-669-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5392
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: