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General NPI Number Information
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NPI Number | 1649897265
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Entity Type | Individual
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Provider Name | MISS EMILY JUDITH ROLON SANTIAGO
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Gender | Female
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | URB. LAS FUENTES DE COAMO 1234 CALLE SANTA ISABEL
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City | COAMO
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State | PR
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Zip | 00769-9318
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Country | US
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Telephone | 787-205-7784
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Fax |
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Provider Business Mailing Address
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Address Line | URB. LAS FUENTES DE COAMO 1234 CALLE SANTA ISABEL
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City | COAMO
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State | PR
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Zip | 00769-9318
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Country | US
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Telephone | 787-205-7784
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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 | 7615
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License Number State | PR
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