Healthcare Provider Details

I. General information

NPI: 1255109724
Provider Name (Legal Business Name): KARIELY KRYSTAL MONGE ALVAREZ PSYD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BARRIO LOS LLANOS, CARRETERA 14, KM 26.8
COAMO PR
00769
US

IV. Provider business mailing address

20 RIO CANAS ABAJO
JUANA DIAZ PR
00795-9122
US

V. Phone/Fax

Practice location:
  • Phone: 939-246-7632
  • Fax:
Mailing address:
  • Phone: 939-246-7632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7831
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: