Basic Information
| Provider Information | |||||||||
| NPI: | 1932124310 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVILA | ||||||||
| FirstName: | DAMARIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 CALLE VENUS | ||||||||
| Address2: | EL VERDE | ||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007256315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877432967 | ||||||||
| FaxNumber: | 7877433323 | ||||||||
| Practice Location | |||||||||
| Address1: | 435 AVE HOSTOS | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009183014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877539515 | ||||||||
| FaxNumber: | 7877538327 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2540 | PR | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.