Healthcare Provider Details

I. General information

NPI: 1891455713
Provider Name (Legal Business Name): JOAN M QUINONES TORRES PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2021
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. INDUSTRIAL REPARADA 2 396 DR. LUIS F. SALA
PONCE PR
00716
US

IV. Provider business mailing address

HC 1 BOX 8932
PENUELAS PR
00624-9223
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-2525
  • Fax:
Mailing address:
  • Phone: 787-380-3119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7231
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: