Provider Demographics
NPI:1427106293
Name:TORRRES, WANDIVETTE (PHD)
Entity type:Individual
Prefix:DR
First Name:WANDIVETTE
Middle Name:
Last Name:TORRRES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#98 URB. PRADOS DE DORADO SUR
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-365-0945
Mailing Address - Fax:
Practice Address - Street 1:277 CALLE MENDEZ VIGO
Practice Address - Street 2:DORADO THERAPY AND EVALUATION CENTER SUITE 277
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4930
Practice Address - Country:US
Practice Address - Phone:787-796-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1384103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical