Provider Demographics
NPI:1013290790
Name:IRIZARRY-TORO, ANA IVETTE (MA)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:IVETTE
Last Name:IRIZARRY-TORO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:ANA
Other - Middle Name:I
Other - Last Name:IRIZARRY-TORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:94 CALLE MARMOL
Mailing Address - Street 2:URB. PEDREGAL
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-8518
Mailing Address - Country:US
Mailing Address - Phone:939-640-2761
Mailing Address - Fax:
Practice Address - Street 1:94 CALLE MARMOL
Practice Address - Street 2:URB. PEDREGAL
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-8518
Practice Address - Country:US
Practice Address - Phone:939-640-2761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4007103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling