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General NPI Number Information
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NPI Number | 1063234565
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Entity Type | Organization
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Legal Business Name | RELEASE PSYCHOLOGY GROUP
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 155 CALLE ANDRES ARUS RIVERA W
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City | GURABO
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State | PR
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Zip | 00778-2321
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Country | US
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Telephone | 939-891-0533
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Fax |
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Provider Business Mailing Address
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Address Line | 41 HACIENDA PARQUE
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City | SAN LORENZO
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State | PR
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Zip | 00754-9633
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Country | US
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Telephone | 939-891-0533
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. KARLA BAEZ RIOS
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Credential |
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Telephone | 939-891-0533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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