Provider Demographics
NPI:1174826382
Name:TIRADO, CARMEN YOLANDA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:YOLANDA
Last Name:TIRADO
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 1:251 CALLE PILON
Mailing Address - Street 2:URB. BORINQUEN VALLEY
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-9825
Mailing Address - Country:US
Mailing Address - Phone:787-557-0015
Mailing Address - Fax:
Practice Address - Street 1:251 CALLE PILON
Practice Address - Street 2:URB. BORINQUEN VALLEY
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-9825
Practice Address - Country:US
Practice Address - Phone:787-557-0015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3822103TC0700X
PR41961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical