Provider Demographics
NPI:1053648592
Name:TORRES CORDERO, ILEANA A (PHD)
Entity type:Individual
Prefix:MRS
First Name:ILEANA
Middle Name:A
Last Name:TORRES CORDERO
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 7444
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-7444
Mailing Address - Country:US
Mailing Address - Phone:787-505-8464
Mailing Address - Fax:
Practice Address - Street 1:74 CALLE SALVADOR BRAU SUITE 01-B
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-3412
Practice Address - Country:US
Practice Address - Phone:787-505-8464
Practice Address - Fax:787-265-8145
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2153103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling