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General NPI Number Information
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NPI Number | 1902821408
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Entity Type | Individual
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Provider Name | GABRIELA M RODRIGUEZ NIELSEN PHD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FERNANDEZ JUNCOS CAROLINA MEDICAL PLAZA A-1
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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 | 787-641-0774
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Fax | 787-641-0776
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Provider Business Mailing Address
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Address Line | PO BOX 71474 APS PROVEEDORES
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City | SAN JUAN
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State | PR
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Zip | 00936-8574
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Country | US
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Telephone | 787-641-0774
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Fax | 787-641-0776
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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 | 2358
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License Number State | PR
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