Healthcare Provider Details

I. General information

NPI: 1780502724
Provider Name (Legal Business Name): DANIZA IDABELLE ROBLES MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

K9 CALLE MYRNA
TOA BAJA PR
00949-4552
US

IV. Provider business mailing address

K9 CALLE MYRNA
TOA BAJA PR
00949-4552
US

V. Phone/Fax

Practice location:
  • Phone: 787-702-1952
  • Fax:
Mailing address:
  • Phone: 787-702-1952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number9165
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: