Provider Demographics
NPI:1073356135
Name:BRAVO-SAAVEDRA, MARIA ISABEL (PHD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:BRAVO-SAAVEDRA
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:URB. ALMIRA
Mailing Address - Street 2:AD-17 11 STREET
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4045
Mailing Address - Country:US
Mailing Address - Phone:939-218-2272
Mailing Address - Fax:
Practice Address - Street 1:1226 CALLE CADIZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-3841
Practice Address - Country:US
Practice Address - Phone:787-428-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004848103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty