Provider Demographics
NPI:1508228990
Name:JOY CACERES, ISABEL CRISTINA (MS PHL)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:CRISTINA
Last Name:JOY CACERES
Suffix:
Gender:F
Credentials:MS PHL
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 1637
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1637
Mailing Address - Country:US
Mailing Address - Phone:787-613-8845
Mailing Address - Fax:
Practice Address - Street 1:D15 CALLE MCKINLEY
Practice Address - Street 2:URB FLAMBOYAN
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-921-2543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist