Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XM0800X | Mental Health | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics | 1146 | PR |
NPI | 1679825319 |
---|---|
Provider Name | Marlene Rosario Abreu |
First Address | Canovanas, PR 00729-1503 |
Second Address | Carolina, PR 00787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2012 |
Last Update Date | 15/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4484066 | DRIVER'S LICENSE (01) | PR |