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General NPI Number Information
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NPI Number | 1639501562
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Entity Type | Individual
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Provider Name | MARI ROSA VELEZ PH D
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Gender | Female
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | CARR 103 INTERIOR KM12.1 VILLA MILAGROS CASA 6
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City | CABO ROJO
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State | PR
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Zip | 00623-0062
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Country | US
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Telephone | 787-307-1885
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Fax |
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Provider Business Mailing Address
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Address Line | CASA 6 URB. VILLA MILAGROS
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City | CABO ROJO
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State | PR
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Zip | 00623-0062
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Country | US
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Telephone | 787-307-1885
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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 | 5171
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License Number State | PR
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