Provider Demographics
NPI:1568499564
Name:MARRERO, JOSE ANGEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANGEL
Last Name:MARRERO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PG5 VIA HORIZONTE
Mailing Address - Street 2:URB. PACIFICA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6146
Mailing Address - Country:US
Mailing Address - Phone:787-365-4675
Mailing Address - Fax:787-641-4555
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:116B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-641-4555
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR688103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical