| Doctor Name: | DR. MAYRA IVELISSE ROBLES |
| NPI Number: | 1043340458 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2292 |
| Business Practice Address: | Gj15 Ave Campo Rico Carolina, PR - 009822656 |
| Business Phone Number: | 7872571860 |
| Business Fax Number: | |
| Mailing Address: | H24 Calle Miguel A Gomez, Idamaris Gardens CAGUAS |
| State: | PR |
| Postal Code: | 007275718 |
| Phone Number: | 9399402601 |
| Fax Number: | |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2292 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |