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General NPI Number Information
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NPI Number | 1225448152
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Entity Type | Individual
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Provider Name | LORELBA ROSADO HERNANDEZ PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 355 AVE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791-3249
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Country | US
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Telephone | 939-630-7293
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 980
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City | JUNCOS
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State | PR
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Zip | 00777-0980
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Country | US
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Telephone | 939-630-7293
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 005581
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License Number State | PR
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