Provider Demographics
NPI:1063857050
Name:ARSUAGA, ENRIQUE N (PHD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:N
Last Name:ARSUAGA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 CALLE REY GUSTAVO
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3262
Mailing Address - Country:US
Mailing Address - Phone:787-717-7642
Mailing Address - Fax:
Practice Address - Street 1:261 CALLE REY GUSTAVO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3262
Practice Address - Country:US
Practice Address - Phone:787-717-7642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical