Provider Demographics
NPI:1063490662
Name:SANCHEZ-CARBO, IVETTE (PHD)
Entity Type:Individual
Prefix:MS
First Name:IVETTE
Middle Name:
Last Name:SANCHEZ-CARBO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10123 SENATE DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4367
Mailing Address - Country:US
Mailing Address - Phone:301-459-9840
Mailing Address - Fax:
Practice Address - Street 1:8737 COLESVILLE RD
Practice Address - Street 2:700
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3928
Practice Address - Country:US
Practice Address - Phone:240-296-5624
Practice Address - Fax:301-588-8880
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04566103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
W04717Medicare UPIN