Provider Demographics
NPI:1720336811
Name:DIAZ ARROYO, CHARMAINE MARIE
Entity Type:Individual
Prefix:DR
First Name:CHARMAINE
Middle Name:MARIE
Last Name:DIAZ ARROYO
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 1:361 CALLE DEL PARQUE
Mailing Address - Street 2:MAGDALENA TOWER 6F
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912-3703
Mailing Address - Country:US
Mailing Address - Phone:787-923-5929
Mailing Address - Fax:
Practice Address - Street 1:453 CALLE CESAR GONZALEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2638
Practice Address - Country:US
Practice Address - Phone:787-392-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3868103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical