Provider Demographics
NPI:1154954329
Name:DE PENA FIGARO, NOELIA SR (MA)
Entity type:Individual
Prefix:MISS
First Name:NOELIA
Middle Name:
Last Name:DE PENA FIGARO
Suffix:SR
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 1:1138 CALLE 16 SE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-2224
Mailing Address - Country:US
Mailing Address - Phone:787-907-8486
Mailing Address - Fax:
Practice Address - Street 1:CANOVANAS MALL ENRIQUE MANGUAL
Practice Address - Street 2:LOCAL 14
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-0072
Practice Address - Country:US
Practice Address - Phone:787-382-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6205103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty