Healthcare Provider Details

I. General information

NPI: 1831001981
Provider Name (Legal Business Name): TINY TRUNKS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AGUADILLA MEDICAL SERVICCARR # 2, KM 129.3, BO VICTORIA OFICINA 100
AGUADILLA PR
00603
US

IV. Provider business mailing address

47 URB VISTA VERDE
CAMUY PR
00627-3302
US

V. Phone/Fax

Practice location:
  • Phone: 787-233-3722
  • Fax:
Mailing address:
  • Phone: 787-346-4172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MISS IDANARA T OCASIO QUINONES
Title or Position: PRESIDENT
Credential:
Phone: 787-346-4172