Provider Demographics
NPI:1073975744
Name:IRIZARRY, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:IRIZARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CALLE MINIMA
Mailing Address - Street 2:URB LAS MINIMAS
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-4909
Mailing Address - Country:US
Mailing Address - Phone:939-644-2406
Mailing Address - Fax:
Practice Address - Street 1:23 URB LAS MINIMAS CALLE MINIMA
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00736
Practice Address - Country:UM
Practice Address - Phone:939-644-2406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist