Provider Demographics
NPI:1164844908
Name:OBEN, ADRIANA LIZ (PHD)
Entity type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:LIZ
Last Name:OBEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B21 VEREDA TROPICAL
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7510
Mailing Address - Country:US
Mailing Address - Phone:787-922-0048
Mailing Address - Fax:
Practice Address - Street 1:B21 VEREDA TROPICAL
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7510
Practice Address - Country:US
Practice Address - Phone:787-922-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5510103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist