Healthcare Provider Details

I. General information

NPI: 1184543068
Provider Name (Legal Business Name): IVANIA IVETTE GUILLOTY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO. QUEBRADA CRUZ, SECTOR LOS PACHECO CARR. 824 KM 8.0
TOA ALTA PR
00953
US

IV. Provider business mailing address

BO. QUEBRADA CRUZ, SECTOR LOS PACHECO CARR. 824 KM 8.0
TOA ALTA PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 787-446-5922
  • Fax:
Mailing address:
  • Phone: 787-446-5922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number007955
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: