Provider Demographics
NPI:1437863941
Name:TORRES PADIN, GISSELLE M (PSY)
Entity type:Individual
Prefix:
First Name:GISSELLE
Middle Name:M
Last Name:TORRES PADIN
Suffix:
Gender:F
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 AVE AMERICO MIRANDA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4632
Mailing Address - Country:US
Mailing Address - Phone:787-515-2511
Mailing Address - Fax:
Practice Address - Street 1:602 AVE MUNOZ RIVERA STE 203
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3625
Practice Address - Country:US
Practice Address - Phone:787-515-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6445103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling