Healthcare Provider Details

I. General information

NPI: 1588092134
Provider Name (Legal Business Name): DAIBER NAILEEN CARRION MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 172 KM 7.6 BO. CERTENEJAS
CIDRA PR
00739-9719
US

IV. Provider business mailing address

D11 CALLE C BAIROA GOLDEN GATE 1
CAGUAS PR
00727-1156
US

V. Phone/Fax

Practice location:
  • Phone: 787-714-4000
  • Fax: 787-714-4000
Mailing address:
  • Phone: 787-714-4000
  • Fax: 787-714-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5298
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number5298
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number5298
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number5298
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number5298
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number5298
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number5298
License Number StatePR
# 8
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number5298
License Number StatePR
# 9
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number5298
License Number StatePR
# 10
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number5298
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: