Individual
DR. MACARENA MAYERLE CORRAL
Active
Individual
DR. MACARENA MAYERLE CORRAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
5396
MN
103TC0700X
Clinical Psychologist
Primary
5396
MN
103TC2200X
Clinical Child & Adolescent Psychologist
5396
MN
103TF0000X
Family Psychologist
5396
MN
103TF0200X
Forensic Psychologist
5396
MN
103TP2701X
Group Psychotherapy Psychologist
5396
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750552196
BCBS
MN
05
—
87055600
—
MN
01
—
C01290
MEDICARE PTAN
MN
Enumeration date
10/11/2011
Last updated
09/07/2023
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