Provider Demographics
NPI:1871300848
Name:LORENZI RODRIGUEZ, LORELYS MARIE
Entity type:Individual
Prefix:
First Name:LORELYS
Middle Name:MARIE
Last Name:LORENZI RODRIGUEZ
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:CA29 URB LA MARGARITA
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-2718
Mailing Address - Country:US
Mailing Address - Phone:787-709-3063
Mailing Address - Fax:
Practice Address - Street 1:CA29 URB LA MARGARITA
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-2718
Practice Address - Country:US
Practice Address - Phone:787-709-3063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8182103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling