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General NPI Number Information
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NPI Number | 1114779873
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Entity Type | Organization
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Legal Business Name | PSICOLOGIA AMOR & ARTE LLC
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | PASEO SAN ISIDRO SUITE #2 CARR.188 KM 2.0 ESQUINA C/6 Y C6A
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City | CANOVANAS
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State | PR
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Zip | 00729-0697
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Country | US
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Telephone | 787-957-6608
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 697
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-368-4614
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Fax |
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Authorized Official
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Title or Position | OWNWER/ DIRECTOR
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Name | DR. LUZ YIRAIDA GONZALEZ RODRIGUEZ
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Credential | PHD.
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Telephone | 787-957-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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