Provider Demographics
NPI:1770276446
Name:GARCIA MIRANDA, ARLENE GISELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:GISELLE
Last Name:GARCIA MIRANDA
Suffix:
Gender:F
Credentials:PHD
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 6909
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-5909
Mailing Address - Country:US
Mailing Address - Phone:516-353-6380
Mailing Address - Fax:
Practice Address - Street 1:URB HACIENDA DEL NORTE AA3 AVE DON PELAYO
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-5388
Practice Address - Country:US
Practice Address - Phone:787-251-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7541103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical