Provider Demographics
NPI:1497967483
Name:DUCRET RAMU, CARMEN R
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:R
Last Name:DUCRET RAMU
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:JJ-4 MIDDLE ST.
Mailing Address - Street 2:ALTURAS DE BORINQUEN GARDEN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0000
Mailing Address - Country:US
Mailing Address - Phone:787-731-7950
Mailing Address - Fax:
Practice Address - Street 1:CENTRO SERVICIOS INTEGRADOS DE RECUPERACION
Practice Address - Street 2:RR9 BOX 887
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9203
Practice Address - Country:US
Practice Address - Phone:787-755-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001203103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
6644-2402OtherAMERICAN PSYCOLOGICAL AS.