Healthcare Provider Details

I. General information

NPI: 1558315051
Provider Name (Legal Business Name): MARIA DEL CARMEN PUIG-CASAURANC PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 CONNECTICUT AVE NW SUITE 400B
WASHINGTON DC
20008-2509
US

IV. Provider business mailing address

3000 CONNECTICUT AVE NW SUITE 400B
WASHINGTON DC
20008-2509
US

V. Phone/Fax

Practice location:
  • Phone: 202-265-5522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1133
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: