Provider Demographics
NPI:1568740371
Name:TORRES, GLENDA (PSY)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-08 BOX 51711
Mailing Address - Street 2:BO. BUENA VISTA
Mailing Address - City:HATILLO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00659
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HC-08 BOX 51711
Practice Address - Street 2:BO. BUENA VISTA
Practice Address - City:HATILLO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00659
Practice Address - Country:UM
Practice Address - Phone:787-420-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3314390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program