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General NPI Number Information
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NPI Number | 1619680428
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Entity Type | Individual
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Provider Name | NAIXA MARI RODRIGUEZ GONZALEZ MS
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Gender | Female
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | CAPITAN II, PR-2 KM 1.59 AVENIDA HOSTOS, 828 VILLA ZORAIDA SUITE 202
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 939-499-5888
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Fax |
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Provider Business Mailing Address
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Address Line | 314 PRADERAS DEL RIO FLORES
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City | SABANA GRANDE
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State | PR
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Zip | 00637-2642
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Country | US
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Telephone | 787-934-7541
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 7250
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License Number State | PR
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