Provider Demographics
NPI:1982058806
Name:DELGADO, ANEL
Entity type:Individual
Prefix:
First Name:ANEL
Middle Name:
Last Name:DELGADO
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 1:312 AVE SAN MARCOS
Mailing Address - Street 2:URB EL COMANDANTE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-3759
Mailing Address - Country:US
Mailing Address - Phone:787-207-2689
Mailing Address - Fax:
Practice Address - Street 1:312 AVE SAN MARCOS
Practice Address - Street 2:URB EL COMANDANTE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-3759
Practice Address - Country:US
Practice Address - Phone:787-207-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2458103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool