Healthcare Provider Details

I. General information

NPI: 1598647992
Provider Name (Legal Business Name): GRETCHELLE L DILAN PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. GRETCHELLE L DILAN

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CALLE LEON
PONCE PR
00730-3717
US

IV. Provider business mailing address

6 CALLE LEON
PONCE PR
00730-3717
US

V. Phone/Fax

Practice location:
  • Phone: 787-409-1516
  • Fax:
Mailing address:
  • Phone: 787-409-1516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number7690
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: