Provider Demographics
NPI:1629200472
Name:MARRRO, SANDRA
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:MARRRO
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 1:118-25 CALLE 67
Mailing Address - Street 2:3RA. SECCION VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5301
Mailing Address - Country:US
Mailing Address - Phone:787-753-9515
Mailing Address - Fax:787-296-1691
Practice Address - Street 1:405 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3014
Practice Address - Country:US
Practice Address - Phone:787-753-9515
Practice Address - Fax:787-296-1691
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional