Provider Demographics
NPI:1548077159
Name:CINTRON-RODRIGUEZ, BRENDA MARIEL (MS)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:MARIEL
Last Name:CINTRON-RODRIGUEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 15098
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-9606
Mailing Address - Country:US
Mailing Address - Phone:787-598-3795
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 15098
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-9606
Practice Address - Country:US
Practice Address - Phone:787-598-3795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8126103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool