Provider Demographics
NPI:1619284619
Name:LUNA, BARBARA ENID (MPYC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ENID
Last Name:LUNA
Suffix:
Gender:F
Credentials:MPYC
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 206
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-0206
Mailing Address - Country:US
Mailing Address - Phone:787-617-0941
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE WILLIE ROSARIO
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-3217
Practice Address - Country:US
Practice Address - Phone:787-803-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-12
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3776103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling