Provider Demographics
NPI:1043051881
Name:RODRIGUEZ-MALDONA, WILKA MARIER
Entity type:Individual
Prefix:
First Name:WILKA
Middle Name:MARIER
Last Name:RODRIGUEZ-MALDONA
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:HC 5 BOX 11278
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-9591
Mailing Address - Country:US
Mailing Address - Phone:787-322-0750
Mailing Address - Fax:
Practice Address - Street 1:HC 5 BOX 11278
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-9591
Practice Address - Country:US
Practice Address - Phone:787-322-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008029103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist