Provider Demographics
NPI:1285846527
Name:PARRILLA, SARA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:M
Last Name:PARRILLA
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:PO BOX 362492
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2492
Mailing Address - Country:US
Mailing Address - Phone:787-781-5623
Mailing Address - Fax:787-781-5643
Practice Address - Street 1:1309 CALLE DELTA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-5019
Practice Address - Country:US
Practice Address - Phone:787-781-5623
Practice Address - Fax:787-781-5643
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR856103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent