Provider Demographics
NPI:1821981036
Name:CENTENO BETANCES, BRENDA
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:CENTENO BETANCES
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:PLAZA DE SALUD SANOS AVE. RAFAEL CORDERO FINAL
Mailing Address - Street 2:AVE. RAFAEL CORDERO FINAL, ESQUINA TROCHE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-0000
Mailing Address - Country:US
Mailing Address - Phone:787-747-1374
Mailing Address - Fax:
Practice Address - Street 1:PLAZA DE SALUD SANOS AVE. RAFAEL CORDERO FINAL
Practice Address - Street 2:AVE. RAFAEL CORDERO FINAL, ESQUINA TROCHE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-747-1374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7781103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool