Healthcare Provider Details

I. General information

NPI: 1790600823
Provider Name (Legal Business Name): KAROLA NICOLE MARRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB VILLA CARMEN CALLE ARECIBO O 29
CAGUAS PR
00725
US

IV. Provider business mailing address

URB. VILLA CARMEN CALLE ARECIBO O 29
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-692-0207
  • Fax:
Mailing address:
  • Phone: 787-692-0207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8771
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: