Provider Demographics
NPI:1437966405
Name:TORRES, IVONNE MARIE
Entity type:Individual
Prefix:
First Name:IVONNE
Middle Name:MARIE
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VEREDAS 42 CALLE 5
Mailing Address - Street 2:CAMINO LOS FLAMBOYANES
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:803-743-6303
Mailing Address - Fax:
Practice Address - Street 1:URB VEREDAS 42 CALLE 5
Practice Address - Street 2:CAMINO LOS FLAMBOYANES
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:803-743-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-13
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8302103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling