Healthcare Provider Details

I. General information

NPI: 1225430671
Provider Name (Legal Business Name): CENTRO DE SERVICIOS PSICOTERAPEUTICOS INTEGRADOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #2 KM. 56.0 PLAZA BARCELONETA #8
BARCELONETA PR
00617
US

IV. Provider business mailing address

PO BOX 827
MANATI PR
00674-0827
US

V. Phone/Fax

Practice location:
  • Phone: 787-378-6513
  • Fax:
Mailing address:
  • Phone: 787-378-6513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4047
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. NILFRA EDMEE SEISE
Title or Position: PRESIDENT
Credential: PSYD
Phone: 787-378-6513