Healthcare Provider Details

I. General information

NPI: 1467509521
Provider Name (Legal Business Name): ANTONIA I NIEVES SANCHEZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 CALLE DR LUIS F. SALAS URB IND REPARADA 2
PONCE PR
00717
US

IV. Provider business mailing address

PO BOX 7004
PONCE PR
00732-7004
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-2575
  • Fax: 787-840-5231
Mailing address:
  • Phone: 787-840-2575
  • Fax: 787-840-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2344
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: