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General NPI Number Information
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NPI Number | 1811911027
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Entity Type | Individual
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Provider Name | MARIA D ARCE FRAGA PHD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 11/27/2017
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Provider Practice Location Address
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Address Line | 107 AVE ORTEGON STE 307
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City | GUAYNABO
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State | PR
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Zip | 00966-2520
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Country | US
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Telephone | 787-234-8987
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Fax |
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Provider Business Mailing Address
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Address Line | 864 AVE ASHFORD APT 607
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City | SAN JUAN
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State | PR
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Zip | 00907-1020
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Country | US
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Telephone | 787-234-8987
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 30
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License Number State | PR
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