Provider Demographics
NPI:1447096995
Name:DELGADO, KRYSTAL DENISSE
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:DENISSE
Last Name:DELGADO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. SOMBRAS DE LA CEIBA #528
Mailing Address - Street 2:CALLE ROBLE
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678
Mailing Address - Country:US
Mailing Address - Phone:863-210-1200
Mailing Address - Fax:
Practice Address - Street 1:URB. SOMBRAS DE LA CEIBA
Practice Address - Street 2:#528 CALLE ROBLE
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:863-210-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7941103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist