Provider Demographics
NPI:1972972503
Name:PIZARRO-CARTAGENA, MAYRA (PHD)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:
Last Name:PIZARRO-CARTAGENA
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:CARR. 110 KM. 24.2
Mailing Address - Street 2:PLAZA CABAN LOCAL #3
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-2069
Mailing Address - Country:US
Mailing Address - Phone:939-349-9821
Mailing Address - Fax:
Practice Address - Street 1:CARR. 110 KM. 24.2
Practice Address - Street 2:PLAZA CABAN LOCAL #3
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605-0060
Practice Address - Country:US
Practice Address - Phone:939-349-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6874103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2005-069OtherUHS NUMBER