Provider Demographics
NPI:1760561732
Name:CARRION-GUZMAN, MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:CARRION-GUZMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 02
Mailing Address - Street 2:BOX 6760
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-9716
Mailing Address - Country:US
Mailing Address - Phone:787-879-2098
Mailing Address - Fax:787-880-6397
Practice Address - Street 1:CARRETERA #2 KM.70.5
Practice Address - Street 2:BO. DOMINGO RUIZ
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9716
Practice Address - Country:US
Practice Address - Phone:787-879-2098
Practice Address - Fax:787-880-6397
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2235103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical