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General NPI Number Information
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NPI Number | 1265250005
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Entity Type | Individual
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Provider Name | MELANIE A CARABALLO MS
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | SAN FERNANDO PLAZA, OFICINA 201, CALLE IGNACIO ARZUAGA
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-430-2525
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Fax |
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Provider Business Mailing Address
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Address Line | URB METROPOLIS CALLE 2A33 CALLE 32A
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City | CAROLINA
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State | PR
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Zip | 00987
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Country | US
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Telephone | 939-218-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 7776
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License Number State | PR
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