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General NPI Number Information
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NPI Number | 1730467598
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Entity Type | Individual
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Provider Name | IDALISABEL RODRIGUEZ GINES PSY.D
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Gender | Female
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 07/28/2011
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Provider Practice Location Address
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Address Line | AVENIDA CAMPO RICO ESQ. CALLE NUM. 7 CALLE 8 BLOQUE 4 NUM.1 SABANA GARDENS
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-762-4646
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Fax |
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Provider Business Mailing Address
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Address Line | URB. VILLA CAROLINA 439 ST. BLOQ. 173-6
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-378-7670
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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 | 3942
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License Number State | PR
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