Healthcare Provider Details

I. General information

NPI: 1649060179
Provider Name (Legal Business Name): KIRSYS IBARRA SANCHEZ MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 17 AQ 42 REPARTO VALENCIA
BAYAMON PR
00959
US

IV. Provider business mailing address

CALLE 17 AQ 42 REPARTO VALENCIA
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-610-6663
  • Fax:
Mailing address:
  • Phone: 787-610-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2535
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: