Provider Demographics
NPI:1548466576
Name:TORRES, CLARISSA
Entity type:Individual
Prefix:MISS
First Name:CLARISSA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 330 KM 1.6 DUEY BAJO
Mailing Address - Street 2:HC 02 BOX 12910
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-892-8693
Mailing Address - Fax:
Practice Address - Street 1:CENTRO SALUD MENTAL MAYAGUEZ
Practice Address - Street 2:410 AVE. HOSTOS SUITE 7
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1522
Practice Address - Country:US
Practice Address - Phone:787-833-3675
Practice Address - Fax:787-831-2095
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator