Provider Demographics
NPI:1417318288
Name:ROCHE TORRES, IRISBEL
Entity Type:Individual
Prefix:
First Name:IRISBEL
Middle Name:
Last Name:ROCHE TORRES
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 1:7 CALLE PARQUE DEL TESORO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-9998
Mailing Address - Country:US
Mailing Address - Phone:787-477-0792
Mailing Address - Fax:
Practice Address - Street 1:7 PARQUE DEL TESORO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-9998
Practice Address - Country:US
Practice Address - Phone:787-477-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3084235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist