Healthcare Provider Details

I. General information

NPI: 1689559130
Provider Name (Legal Business Name): SERVICIOS PSICOLOGICOS INTEGRALES DRA HAYDEE ENID LOPEZ DAVILA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOCAL 2 CARR 188 KM 2.0 CALLE 6
CANOVANAS PR
00729-0697
US

IV. Provider business mailing address

8325 CALLE BELMONTE
LOIZA PR
00772-9757
US

V. Phone/Fax

Practice location:
  • Phone: 787-314-7605
  • Fax:
Mailing address:
  • Phone: 787-314-7605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. HAYDEE ENID LOPEZ DAVILA
Title or Position: PSYCHOLOGISTS
Credential: PH.D.
Phone: 787-314-7605