Provider Demographics
NPI:1861245334
Name:TORRES, CLARISSA MICHELLE
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:MICHELLE
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 1:430 CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:BARRIGADA
Mailing Address - State:GU
Mailing Address - Zip Code:96913-1158
Mailing Address - Country:US
Mailing Address - Phone:671-483-2287
Mailing Address - Fax:
Practice Address - Street 1:131 HAIGUAS DR
Practice Address - Street 2:
Practice Address - City:AGANA HEIGHTS
Practice Address - State:GU
Practice Address - Zip Code:96910-6498
Practice Address - Country:US
Practice Address - Phone:671-483-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist