Provider Demographics
NPI:1952788655
Name:CANDELARIO, CATHERINE (PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CANDELARIO
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 65 BOX 4348
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-9319
Mailing Address - Country:US
Mailing Address - Phone:787-361-8015
Mailing Address - Fax:
Practice Address - Street 1:HC 65 BOX 4348
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-9319
Practice Address - Country:US
Practice Address - Phone:787-361-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5311OtherLICENSE NUMBER