Provider Demographics
NPI:1407665276
Name:MUNOZ BERASTAIN, MARIMER (PSYD)
Entity type:Individual
Prefix:
First Name:MARIMER
Middle Name:
Last Name:MUNOZ BERASTAIN
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:EXT. VALLE ALTO
Mailing Address - Street 2:2334 CALLE LOMAS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4145
Mailing Address - Country:US
Mailing Address - Phone:787-601-3541
Mailing Address - Fax:
Practice Address - Street 1:2004 CARR 506 STE 201
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2936
Practice Address - Country:US
Practice Address - Phone:787-840-7391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8210103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist