Provider Demographics
NPI:1972087260
Name:IRIZARRY-ROBLES, CAROL Y (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:Y
Last Name:IRIZARRY-ROBLES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:IRIZARRY ROBLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19273
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-1273
Mailing Address - Country:US
Mailing Address - Phone:787-450-5002
Mailing Address - Fax:
Practice Address - Street 1:36 CARR 20 STE 301
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-3332
Practice Address - Country:US
Practice Address - Phone:787-800-9294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5812103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical