Provider Demographics
NPI:1811767064
Name:VARGAS ALVAREZ, VICMARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:VICMARIE
Middle Name:
Last Name:VARGAS ALVAREZ
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 1:489 CALLE ORQUIDEA
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-4905
Mailing Address - Country:US
Mailing Address - Phone:939-248-6679
Mailing Address - Fax:
Practice Address - Street 1:INT. CARR 112 KM 1.4
Practice Address - Street 2:SUITE #9
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-460-4616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7883103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical