Provider Demographics
NPI:1952520215
Name:ARRAIZA, MANLIO (MA)
Entity Type:Individual
Prefix:
First Name:MANLIO
Middle Name:
Last Name:ARRAIZA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 AVE ATLANTICO
Mailing Address - Street 2:URB RADIOVILLE
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-2735
Mailing Address - Country:US
Mailing Address - Phone:787-438-9020
Mailing Address - Fax:
Practice Address - Street 1:113
Practice Address - Street 2:CALLE ANTONIO R BARCELO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-816-1256
Practice Address - Fax:787-878-5778
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health