Healthcare Provider Details

I. General information

NPI: 1841767860
Provider Name (Legal Business Name): ANNETTE D ROMAN-MARRERO PH.D., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 08/15/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE S CUEVAS BUSTAMANTE, URB. PARQ. CENTRAL 525
SAN JUAN PR
00918-2642
US

IV. Provider business mailing address

525 CALLE CUEVAS BUSTAMANTE PARQ CENTRAL
SAN JUAN PR
00918-2642
US

V. Phone/Fax

Practice location:
  • Phone: 787-614-9285
  • Fax:
Mailing address:
  • Phone: 787-614-9285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7617
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number7617
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7617
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: