Provider Demographics
NPI:1932474814
Name:TORRES, MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:
Last Name:TORRES
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:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0626
Mailing Address - Country:US
Mailing Address - Phone:787-920-4899
Mailing Address - Fax:
Practice Address - Street 1:ESTANCIAS DE BARCELONETA #253
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-0000
Practice Address - Country:US
Practice Address - Phone:787-920-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0294101YP2500X
PR4220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional