Basic Information
| Provider Information | |||||||||
| NPI: | 1568680064 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAREDES | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | EUGENIA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PH.D(C) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27 CALLE LIMONCILLO | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009276622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874587031 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | UNIVERSITY OF PUERTO RICO | ||||||||
| Address2: | MEDICAL CAMPUS DEPARTMENT OD PSHYCHIATRY 9 FLOOR | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009365067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 1500 | PR | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.