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General NPI Number Information
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NPI Number | 1366165201
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Entity Type | Individual
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Provider Name | JOANNA M PEREIRA-ROMERO MCPL
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | CARRETERA 967 KM. 1.3 SECTOR LAS 3T
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City | RIO GRANDE
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State | PR
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Zip | 00745-2086
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Country | US
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Telephone | 939-645-0391
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2086
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City | RIO GRANDE
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State | PR
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Zip | 00745-2086
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Country | US
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Telephone | 939-645-0391
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2109
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License Number State | PR
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