Provider Demographics
NPI:1023533254
Name:CARRERO GIRALD, TERESA T
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:T
Last Name:CARRERO GIRALD
Suffix:
Gender:F
Credentials:
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 512
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0512
Mailing Address - Country:US
Mailing Address - Phone:787-214-0409
Mailing Address - Fax:
Practice Address - Street 1:602 CALLE HOARE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3614
Practice Address - Country:US
Practice Address - Phone:787-214-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5775103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical