Provider Demographics
NPI:1982931093
Name:ARZOLA- CARABALLO, EMMA R (LCSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:R
Last Name:ARZOLA- CARABALLO
Suffix:
Gender:F
Credentials:LCSW
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 995
Mailing Address - Street 2:CAR# 536 KM 2.6 BO. DESCALABRADO
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-0995
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:92 CALLE SOL
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3669
Practice Address - Country:US
Practice Address - Phone:787-841-8855
Practice Address - Fax:787-841-8855
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR100671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical