Provider Demographics
NPI:1083837678
Name:VALE, CARLOS ARIEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ARIEL
Last Name:VALE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APARTADO 578
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9617
Mailing Address - Country:US
Mailing Address - Phone:787-637-9036
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 KM 7.1
Practice Address - Street 2:EDIFICIO PLAZA SOL BO. VOLADORAS
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-0578
Practice Address - Country:US
Practice Address - Phone:787-637-9036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2513103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical