Healthcare Provider Details

I. General information

NPI: 1932854064
Provider Name (Legal Business Name): CENTRO DE DESARROLLO PARA LA NINEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 CALLE DUFRESNE W
HUMACAO PR
00791-3610
US

IV. Provider business mailing address

VILLAS DE CANDELERO CLL GOLONDRINA 52
HUMACAO PR
00791
US

V. Phone/Fax

Practice location:
  • Phone: 787-944-6971
  • Fax:
Mailing address:
  • Phone: 787-944-6971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KATIUSKA VAZQUEZ
Title or Position: SPEECH PATHOLOGISTS- MANAGER
Credential:
Phone: 787-944-6971