Provider Demographics
NPI:1689966988
Name:MALAVET, EMILY LORRAINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LORRAINE
Last Name:MALAVET
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:N1 CALLE BORIKEN
Mailing Address - Street 2:ALTURAS DEL ENCANTO
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-2723
Mailing Address - Country:US
Mailing Address - Phone:787-601-5604
Mailing Address - Fax:787-837-4742
Practice Address - Street 1:52 CALLE DR VEVE
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-1651
Practice Address - Country:US
Practice Address - Phone:787-601-5604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3902103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical