Healthcare Provider Details

I. General information

NPI: 1659694446
Provider Name (Legal Business Name): ENA L GARCIA-PEREZ PSY D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE BETANCES SUITE 1
MANATI PR
00674-5117
US

IV. Provider business mailing address

PO BOX 487
MANATI PR
00674-0487
US

V. Phone/Fax

Practice location:
  • Phone: 787-406-4275
  • Fax:
Mailing address:
  • Phone: 787-406-4275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number001284
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: