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Individual

ELISA J RODRIGUEZ TIRADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY D.

Contact information

Practice address
70 CALLE RELAMPAGO, OFICINA 104, BO COLOMBIA, MAYAGUEZ, PR 00680-3583
(787) 903-9405
Mailing address
PO BOX 922, ENSENADA, PR 00647-0922
(787) 903-9405

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7614
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7614
LICENSE
PR
Enumeration date
03/07/2023
Last updated
03/08/2023
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