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General NPI Number Information
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NPI Number | 1558208892
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Entity Type | Individual
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Provider Name | CARLA GABRIELA PRIETO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 720 PIKE ST STE 2
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City | LEMONT
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State | PA
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Zip | 16851-9085
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Country | US
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Telephone | 814-954-7607
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Fax |
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Provider Business Mailing Address
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Address Line | 303 FARMSTEAD LN APT 21
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City | STATE COLLEGE
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State | PA
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Zip | 16803-2520
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Country | US
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Telephone | 406-916-1587
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS020648
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License Number State | PA
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