Provider Demographics
NPI:1093036626
Name:TOSADO, CARMEN V (PSY D)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:V
Last Name:TOSADO
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 BULEVAR SAN LUIS
Mailing Address - Street 2:VILLAS DE LAUREL I
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2243
Mailing Address - Country:US
Mailing Address - Phone:787-568-8865
Mailing Address - Fax:
Practice Address - Street 1:1212 BULEVAR SAN LUIS
Practice Address - Street 2:VILLAS DE LAUREL I
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2243
Practice Address - Country:US
Practice Address - Phone:787-568-8865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1826103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical