Provider Demographics
NPI:1962393322
Name:BADILLO, ROSA ISABEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:ISABEL
Last Name:BADILLO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CALLE LAS VEGAS COMUNIDAD LOS PINOS
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0000
Mailing Address - Country:US
Mailing Address - Phone:787-431-0621
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA AGUSTIN RAMOS CALERO INT.
Practice Address - Street 2:CARR. 112 KM 1.4 SUITE # 9
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-431-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8102103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical