=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003291477
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NORMA ENID RAMOS SOLLA PH.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2015
-----------------------------------------------------
Last Update Date | 07/27/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MONTEMAR APTS # 1523 AVE LAS BRISAS APTO 124
-----------------------------------------------------
City | PONCE
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00728-5222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-929-5280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | MONTEMAR APTS # 1523 AVE LAS BRISAS APTO 124
-----------------------------------------------------
City | PONCE
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00728-5222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-929-5280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 4170
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------