Provider Demographics
NPI:1902611056
Name:VALLEJO, MARIA CAMILA (MS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CAMILA
Last Name:VALLEJO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. ACQUALINA 186 CARR 2
Mailing Address - Street 2:APT 1003
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:602-558-8725
Mailing Address - Fax:
Practice Address - Street 1:COND. ACQUALINA 186 CARR 2
Practice Address - Street 2:APT 1003
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:602-558-8725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8307103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling