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General NPI Number Information
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NPI Number | 1093415390
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Entity Type | Organization
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Legal Business Name | MERCADO ROMAN PSYCHOLOGY GROUP PSC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | CARR 119 KM 5.5 INTERIOR, BO. PUENTE
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City | CAMUY
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State | PR
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Zip | 00627-0062
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Country | US
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Telephone | 787-644-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 162 CALLE HELIO
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City | ARECIBO
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State | PR
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Zip | 00612-8866
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Country | US
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Telephone | 787-644-0743
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAILENE MARIE ROMAN TEJERA
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Credential | PSYD
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Telephone | 787-644-0743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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