Healthcare Provider Details

I. General information

NPI: 1669322517
Provider Name (Legal Business Name): MGS PSICOLOG@S LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CALLE SEVERO ARANA
SAN SEBASTIAN PR
00685-2310
US

IV. Provider business mailing address

700 AVE JOBOS APT 714
ISABELA PR
00662-5507
US

V. Phone/Fax

Practice location:
  • Phone: 787-243-6908
  • Fax:
Mailing address:
  • Phone: 787-243-6908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MAYDA T GRAULAU SANTIAGO
Title or Position: PRESIDENT
Credential: PHD
Phone: 787-243-6908