Healthcare Provider Details

I. General information

NPI: 1114831542
Provider Name (Legal Business Name): SOULS IN MOTION CREATIVE THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO RINCON KM HM 4.0 CARR 189
GURABO PR
00778-5179
US

IV. Provider business mailing address

BO RINCON KM HM 4.0 CARR 189
GURABO PR
00778-5179
US

V. Phone/Fax

Practice location:
  • Phone: 787-925-2515
  • Fax:
Mailing address:
  • Phone: 787-925-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMARILLIS YADIRA VAZQUEZ MORALES
Title or Position: PROVEEDORA
Credential:
Phone: 787-925-2515