Basic Information
| Provider Information | |||||||||
| NPI: | 1326187394 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLAVARRIA | ||||||||
| FirstName: | MAYRA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 365067 | ||||||||
| Address2: | DEPARTAMENTO DE PSIQUIATRIA | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009365067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
| FaxNumber: | 7877647004 | ||||||||
| Practice Location | |||||||||
| Address1: | NINTH FLOOR OFFICE 954 | ||||||||
| Address2: | UPR MEDICAL SCIENCES CAMPUS MAIN BUILDING | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582525 | ||||||||
| FaxNumber: | 7877660940 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2007 | ||||||||
| LastUpdateDate: | 06/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 2273 | PR | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.