Provider Demographics
NPI:1841404621
Name:ESPOSITO-CASAS, MARI C (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MARI
Middle Name:C
Last Name:ESPOSITO-CASAS
Suffix:
Gender:F
Credentials:PSY D
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 3
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0003
Mailing Address - Country:US
Mailing Address - Phone:787-349-6530
Mailing Address - Fax:787-778-3052
Practice Address - Street 1:73 CALLE SANTA CRUZ STE 407
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6942
Practice Address - Country:US
Practice Address - Phone:787-778-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2460103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical