Provider Demographics
NPI:1558122861
Name:ARCELAY, LEMELYS DAMARA
Entity Type:Individual
Prefix:
First Name:LEMELYS
Middle Name:DAMARA
Last Name:ARCELAY
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:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0189
Mailing Address - Country:US
Mailing Address - Phone:787-431-8185
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 109
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0189
Practice Address - Country:US
Practice Address - Phone:787-431-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical