Healthcare Provider Details

I. General information

NPI: 1154046878
Provider Name (Legal Business Name): CENTRO APRENDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CALLE RUFINA
GUAYANILLA PR
00656-1809
US

IV. Provider business mailing address

20 CALLE RUFINA
GUAYANILLA PR
00656-1809
US

V. Phone/Fax

Practice location:
  • Phone: 939-928-9036
  • Fax:
Mailing address:
  • Phone: 939-928-9036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name: ISIAMARA AVILES
Title or Position: DIRECTORA
Credential: BSTHL
Phone: 939-928-9036