Provider Demographics
NPI:1689906638
Name:MARZAN, DAISY (PSYD)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:MARZAN
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:STREET 2 URB. MONTE CARLO
Mailing Address - Street 2:D-985
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-5101
Mailing Address - Country:US
Mailing Address - Phone:787-509-5274
Mailing Address - Fax:
Practice Address - Street 1:AVE. ROBERTO SANCHEZ VILELLA CT-14
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2675
Practice Address - Country:US
Practice Address - Phone:787-276-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2414103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist