Healthcare Provider Details

I. General information

NPI: 1700718889
Provider Name (Legal Business Name): GRISELL WALESKA ROBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB ESTANCIAS DE JUNCOS 155 CAMINO DE LA VEREDA
JUNCOS PR
00777-9426
US

IV. Provider business mailing address

URB ESTANCIAS DE JUNCOS 155 CAMINO DE LA VEREDA
JUNCOS PR
00777-9426
US

V. Phone/Fax

Practice location:
  • Phone: 787-217-4272
  • Fax: 787-217-4272
Mailing address:
  • Phone: 787-217-4272
  • Fax: 787-217-4272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8864
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: