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General NPI Number Information
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NPI Number | 1386148443
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Entity Type | Individual
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Provider Name | MARIE L LOPERENA-MONTALBAN
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Gender | Female
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 357 AVENIDA DE DIEGO ANTIGUO TEATRO SAN LUIS SEGUNDO PISO
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City | ARECIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 787-878-0537
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 607087
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City | BAYAMON
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State | PR
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Zip | 00960-7087
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Country | US
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Telephone | 787-763-7575
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 1025
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License Number State | PR
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