Provider Demographics
NPI:1689073462
Name:CORREA, FRANCISCO (EDDC, CPL, CHT)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:CORREA
Suffix:
Gender:M
Credentials:EDDC, CPL, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H20 VIA PANORAMICA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-4476
Mailing Address - Country:US
Mailing Address - Phone:787-203-0437
Mailing Address - Fax:
Practice Address - Street 1:H20 VIA PANORAMICA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-4476
Practice Address - Country:US
Practice Address - Phone:787-203-0437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2201101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional