Provider Demographics
NPI:1154692499
Name:FIGUEROA, MARA E (MA)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:E
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 CALLE ADUANA
Mailing Address - Street 2:PMB111
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-3299
Mailing Address - Country:US
Mailing Address - Phone:787-649-4213
Mailing Address - Fax:
Practice Address - Street 1:35 CALLE AMISTAD
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-2061
Practice Address - Country:US
Practice Address - Phone:787-649-4213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2974103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist