Provider Demographics
NPI:1033936547
Name:SENIOR, ERICK (PHD)
Entity type:Individual
Prefix:DR
First Name:ERICK
Middle Name:
Last Name:SENIOR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ERICK
Other - Middle Name:ADRIAN
Other - Last Name:SENIOR ROGES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:190 AVE HOSTOS EL MONTE SUR
Mailing Address - Street 2:APT 925
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-955-4737
Mailing Address - Fax:
Practice Address - Street 1:190 AVE HOSTOS EL MONTE SUR
Practice Address - Street 2:APT 925
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4638
Practice Address - Country:US
Practice Address - Phone:787-955-4737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008078103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist