Provider Demographics
NPI:1699910331
Name:CANAS, CARMEN ISABEL (PHD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ISABEL
Last Name:CANAS
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 1:1325 AVE SAN IGNACIO
Mailing Address - Street 2:COND. SAN IGNACIO APT. 8-I
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3814
Mailing Address - Country:US
Mailing Address - Phone:787-759-8102
Mailing Address - Fax:
Practice Address - Street 1:AVE ALEJANDRINO # 9
Practice Address - Street 2:CARR. 838 KM. 0.1
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-7003
Practice Address - Country:US
Practice Address - Phone:787-759-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3086103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling