Provider Demographics
NPI:1427280148
Name:AGRAMONTE, TANZANIA P
Entity type:Individual
Prefix:
First Name:TANZANIA
Middle Name:P
Last Name:AGRAMONTE
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 1:119 CALLE MANUEL CORCHADO
Mailing Address - Street 2:APT 2
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-2206
Mailing Address - Country:US
Mailing Address - Phone:787-675-1613
Mailing Address - Fax:
Practice Address - Street 1:MANUEL CORCHADO 119
Practice Address - Street 2:APT 2
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911
Practice Address - Country:US
Practice Address - Phone:787-675-1613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist