Provider Demographics
NPI:1184057531
Name:CARRION, ANA M
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:M
Last Name:CARRION
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 479
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-0479
Mailing Address - Country:US
Mailing Address - Phone:787-605-5100
Mailing Address - Fax:
Practice Address - Street 1:#2 CALLE 120
Practice Address - Street 2:VILLA NEVAREZ PROFESSIONAL CENTER SUITE 304
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-605-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5224103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical