Provider Demographics
NPI:1457775637
Name:BASMESON, MARIA CARMEN (MS SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CARMEN
Last Name:BASMESON
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AZUCENA # 96 ESTANCIAS DE LA FUENTE
Mailing Address - Street 2:TOA ALTA PUERTO RICO 00953
Mailing Address - City:TOA ALTA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00953
Mailing Address - Country:UM
Mailing Address - Phone:787-636-8346
Mailing Address - Fax:
Practice Address - Street 1:CARR 167 # KM19.2
Practice Address - Street 2:BAYAMON, PUERTO RICO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4477
Practice Address - Country:US
Practice Address - Phone:787-636-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist