Provider Demographics
NPI:1063720704
Name:SANCHEZ, MARICARMEN (ASIST OT)
Entity type:Individual
Prefix:
First Name:MARICARMEN
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:ASIST OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:T17 CALLE 28
Mailing Address - Street 2:VILLA UNIVERSITARIA
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-4355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:T17 CALLE 28
Practice Address - Street 2:VILLA UNIVERSITARIA
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4355
Practice Address - Country:US
Practice Address - Phone:787-224-2811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR657247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other