Provider Demographics
NPI:1104259852
Name:TIRADO-GUERRA, NORMA M
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:M
Last Name:TIRADO-GUERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CQ14 CALLE 11A
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-1426
Mailing Address - Country:US
Mailing Address - Phone:787-428-7798
Mailing Address - Fax:
Practice Address - Street 1:2100 CALLE TURQUESA
Practice Address - Street 2:105
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5130
Practice Address - Country:US
Practice Address - Phone:787-404-5933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5367103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical