Provider Demographics
NPI:1598555955
Name:MAESTRE, ERLEEN JEANETH (PSIC)
Entity type:Individual
Prefix:
First Name:ERLEEN
Middle Name:JEANETH
Last Name:MAESTRE
Suffix:
Gender:
Credentials:PSIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1863
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-1863
Mailing Address - Country:US
Mailing Address - Phone:787-452-7521
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1863
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-1863
Practice Address - Country:US
Practice Address - Phone:787-452-7521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6815103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist