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General NPI Number Information
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NPI Number | 1417239617
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Entity Type | Individual
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Provider Name | MR. CARLOS RAFAEL TORRES
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Gender | Male
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 05/12/2015
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Provider Practice Location Address
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Address Line | 21 CALLE TECA LOS FLAMBOYANES
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City | GURABO
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State | PR
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Zip | 00778-2761
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Country | US
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Telephone | 787-746-6961
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Fax |
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Provider Business Mailing Address
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Address Line | 21 CALLE TECA LOS FLAMBOYANES
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City | GURABO
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State | PR
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Zip | 00778-2761
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Country | US
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Telephone |
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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 | 3963
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1046
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License Number State | PR
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