Provider Demographics
NPI:1629315650
Name:QUILES-PEREZ, DAYRA D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAYRA
Middle Name:D
Last Name:QUILES-PEREZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAGUNA GARDENS SHOPPING CENTER
Mailing Address - Street 2:SUITE 249-2
Mailing Address - City:CAROLINA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00979
Mailing Address - Country:UM
Mailing Address - Phone:787-529-1191
Mailing Address - Fax:
Practice Address - Street 1:LAGUNA GARDENS SHOPPING CENTER
Practice Address - Street 2:SUITE 249-2
Practice Address - City:CAROLINA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00979
Practice Address - Country:UM
Practice Address - Phone:787-529-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4322103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist