MEDICARE: DR. ALICIA MARGARITA OLMO-TERRASA PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2421	PR

General Provider Information

NPI Number	:	1730370099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICIA MARGARITA OLMO-TERRASA PSY.D.

Provider Business Mailing Address
First Line	:	50 CALLE 3
Second Line	:	URB FLAMINGO HILLS
City	:	BAYAMON
State	:	PR
Zip	:	00957-1716
Country	:	US
Telephone Number	:	787-479-9080
Fax Number	:

Provider Business Practice Location Address
First Line	:	COND MAGA
Second Line	:	CENTRO MEDICO RP
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1966
Country	:	US
Telephone Number	:	787-764-0684
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	08/01/2007

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