Provider Demographics
NPI:1306875901
Name:CARRASQUILLO CASTRO, ANABEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANABEL
Middle Name:
Last Name:CARRASQUILLO CASTRO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CALLE DEL CARMEN W
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4717
Mailing Address - Country:US
Mailing Address - Phone:787-860-3558
Mailing Address - Fax:787-860-3330
Practice Address - Street 1:55 CALLE DEL CARMEN W
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4717
Practice Address - Country:US
Practice Address - Phone:787-860-3558
Practice Address - Fax:787-860-3330
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2633103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical