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General NPI Number Information
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NPI Number | 1659673358
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Entity Type | Individual
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Provider Name | AURELINA SEGURA VALENZUELA
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Gender | Female
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 1306 AVE FERNANDEZ JUNCOS PDA 19 SANTURCE
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City | SAN JUAN
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State | PR
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Zip | 00909-2521
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Country | US
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Telephone | 787-480-3028
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Fax | 787-725-8260
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Provider Business Mailing Address
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Address Line | JARDINES DE MONTE ALTO # 325 APT. 41
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-4943
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 189
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1340
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License Number State | PR
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