Provider Demographics
NPI:1578378055
Name:PUERTA, ANAMARIA
Entity type:Individual
Prefix:
First Name:ANAMARIA
Middle Name:
Last Name:PUERTA
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:N7 AVE DIEGO VELAZQUEZ
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6456
Mailing Address - Country:US
Mailing Address - Phone:787-616-4333
Mailing Address - Fax:
Practice Address - Street 1:N7 AVE DIEGO VELAZQUEZ
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6456
Practice Address - Country:US
Practice Address - Phone:787-616-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6944103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling