Provider Demographics
NPI:1871838045
Name:CRISTOBAL, DAMARIS ESTHER (MPSY)
Entity Type:Individual
Prefix:MRS
First Name:DAMARIS
Middle Name:ESTHER
Last Name:CRISTOBAL
Suffix:
Gender:F
Credentials:MPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SEGOVIA ST. 503 VISTAMAR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-410-6613
Mailing Address - Fax:
Practice Address - Street 1:503 CALLE SEGOVIA
Practice Address - Street 2:URB. VISTAMAR
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-1426
Practice Address - Country:US
Practice Address - Phone:787-410-6613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3860103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling