Provider Demographics
NPI:1437389392
Name:ROSARIO-FELICIANO, GLORIMAR (MA-PSYCHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:GLORIMAR
Middle Name:
Last Name:ROSARIO-FELICIANO
Suffix:
Gender:F
Credentials:MA-PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ESTANCIAS DE LA CEIBA 241 CALLE PINO
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:787-206-1901
Mailing Address - Fax:
Practice Address - Street 1:MARGINAL CARR. #2 KM. 84.7
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-206-1901
Practice Address - Fax:787-820-6641
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3404103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist