Healthcare Provider Details

I. General information

NPI: 1932474814
Provider Name (Legal Business Name): MARIE TORRES PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ESTANCIAS DE BARCELONETA #253
BARCELONETA PR
00617-0000
US

IV. Provider business mailing address

PO BOX 626
MANATI PR
00674-0626
US

V. Phone/Fax

Practice location:
  • Phone: 787-920-4899
  • Fax:
Mailing address:
  • Phone: 787-920-4899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0294
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4220
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: