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General NPI Number Information
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NPI Number | 1689906638
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Entity Type | Individual
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Provider Name | DAISY MARZAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | AVE. ROBERTO SANCHEZ VILELLA CT-14 COUNTRY CLUB
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City | CAROLINA
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State | PR
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Zip | 00982-2675
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Country | US
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Telephone | 787-276-2545
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Fax |
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Provider Business Mailing Address
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Address Line | STREET 2 URB. MONTE CARLO D-985
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City | SAN JUAN
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State | PR
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Zip | 00924-5101
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Country | US
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Telephone | 787-509-5274
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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 | 2414
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License Number State | PR
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