Provider Demographics
NPI:1649597683
Name:LLADO, MARIA DEL CARMEN HERNANDEZ (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA DEL CARMEN
Middle Name:HERNANDEZ
Last Name:LLADO
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:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0667
Mailing Address - Country:US
Mailing Address - Phone:787-690-1475
Mailing Address - Fax:
Practice Address - Street 1:4 CALLE MEXICO
Practice Address - Street 2:AREY SUITE 301
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-2203
Practice Address - Country:US
Practice Address - Phone:787-969-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3564103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical