Provider Demographics
NPI:1003057571
Name:TARAFA, NILDA R (PSYCOLOGY-DOCTOR)
Entity Type:Individual
Prefix:MS
First Name:NILDA
Middle Name:R
Last Name:TARAFA
Suffix:
Gender:F
Credentials:PSYCOLOGY-DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366426
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6426
Mailing Address - Country:US
Mailing Address - Phone:787-315-6046
Mailing Address - Fax:787-296-4628
Practice Address - Street 1:COND FIRST FEDERAL 1056
Practice Address - Street 2:SUITE 914 AVE. MUNOZ RIVERA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-315-6046
Practice Address - Fax:787-296-4628
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical