Provider Demographics
NPI:1124366844
Name:CANABAL-TORRES, INES (PHD)
Entity Type:Individual
Prefix:DR
First Name:INES
Middle Name:
Last Name:CANABAL-TORRES
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 1:2765 AVE HOSTOS # 345
Mailing Address - Street 2:MAYAGUEZ VA OUTPATIENT CLINIC
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6353
Mailing Address - Country:US
Mailing Address - Phone:787-834-6900
Mailing Address - Fax:
Practice Address - Street 1:2765 AVE HOSTOS # 345
Practice Address - Street 2:MAYAGUEZ VA OUTPATIENT CLINIC
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6353
Practice Address - Country:US
Practice Address - Phone:787-834-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1534103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling