Healthcare Provider Details

I. General information

NPI: 1730990912
Provider Name (Legal Business Name): ROSS PSYCHOLOGY AND EDUCATION SERVICES PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 358 KM 2.1 INT BO HOCONUCO BAJO
SAN GERMAN PR
00683
US

IV. Provider business mailing address

105 EL DORADO CLB
VEGA ALTA PR
00692-8824
US

V. Phone/Fax

Practice location:
  • Phone: 787-944-5477
  • Fax:
Mailing address:
  • Phone: 787-944-5477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOMAIRA E ROSS CASIANO
Title or Position: PSYCOLOGY
Credential:
Phone: 787-944-5477