Healthcare Provider Details
I. General information
NPI: 1508789652
Provider Name (Legal Business Name): CENTRO DE PSICOLOGIA Y SANACION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8133 CALLE CONCORDIA STE 202
PONCE PR
00717-1543
US
IV. Provider business mailing address
2304 CALLE LOMA URB. VALLE ALTO
PONCE PR
00730-4145
US
V. Phone/Fax
- Phone: 787-466-4287
- Fax:
- Phone: 787-702-3918
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOANIE
MORALES SANTIAGO
Title or Position: OWNER
Credential: PSY D
Phone: 787-702-3918