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General NPI Number Information
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NPI Number | 1528206794
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Entity Type | Individual
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Provider Name | MARIA DE LOURDES LEON
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Gender | Female
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Dates
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Enumeration Date | 01/27/2009
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | AVE. LUIS MUNOZ RIVERA 91
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-845-1188
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Fax | 787-845-1188
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Provider Business Mailing Address
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Address Line | 1642 NAVARRA STREET, LA RAMBLA
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City | PONCE
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State | PR
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Zip | 00730-4058
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Country | US
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Telephone | 787-202-6572
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Fax | 787-845-1188
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2260
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License Number State | PR
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