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General NPI Number Information
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NPI Number | 1336647072
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Entity Type | Individual
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Provider Name | AIDA LUZ GARCIA CARRASQUILLO PHD
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Gender | Female
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 168 AVE BARBOSA
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City | CATANO
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State | PR
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Zip | 00962-4782
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Country | US
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Telephone | 787-788-4544
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Fax | 787-788-4544
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Provider Business Mailing Address
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Address Line | 14 MOUNTAIN VIEW J1
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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 | 787-752-4263
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Fax | 787-788-4544
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1283
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License Number State | PR
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