Provider Demographics
NPI:1124249370
Name:VELAZQUEZ, NORMA (ME)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:ME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALTURAS DE PENUELAS II CALLE 12 F1
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624
Mailing Address - Country:US
Mailing Address - Phone:787-836-5986
Mailing Address - Fax:
Practice Address - Street 1:PABELLON C SEGUNDO PISO ANEXO PSIQUIATRIA FORENSE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732-7321
Practice Address - Country:US
Practice Address - Phone:787-284-1240
Practice Address - Fax:787-844-1144
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR101Y00000X101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor