Provider Demographics
NPI:1215236922
Name:ROS ESCALANTE, MARCELA V (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARCELA
Middle Name:V
Last Name:ROS ESCALANTE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CALLE PIEDRAS NEGRAS
Mailing Address - Street 2:APT. 3302
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4731
Mailing Address - Country:US
Mailing Address - Phone:787-226-8137
Mailing Address - Fax:
Practice Address - Street 1:107 CALLE ORTEGON
Practice Address - Street 2:EDIF. CAPARRA GALLERY SUITE 312
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-226-8137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3951103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical