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General NPI Number Information
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NPI Number | 1851606859
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Entity Type | Individual
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Provider Name | EDDIE WILLIAM MILLAN CARRERO PH. D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | CALLE HACIENDA REAL #85 URB. CAMINO REAL
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City | JUANA DIAZ
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State | PR
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Zip | 00795-0000
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Country | US
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Telephone | 787-380-1419
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE HACIENDA REAL #85 URB. CAMINO REAL
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-380-1419
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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 | 3261
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License Number State | PR
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