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General NPI Number Information
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NPI Number | 1114831542
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Entity Type | Organization
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Legal Business Name | SOULS IN MOTION CREATIVE THERAPY CENTER LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | BO RINCON KM HM 4.0 CARR 189
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City | GURABO
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State | PR
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Zip | 00778-5179
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Country | US
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Telephone | 787-925-2515
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Fax |
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Provider Business Mailing Address
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Address Line | BO RINCON KM HM 4.0 CARR 189
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City | GURABO
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State | PR
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Zip | 00778-5179
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Country | US
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Telephone | 787-925-2515
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Fax |
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Authorized Official
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Title or Position | PROVEEDORA
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Name | AMARILLIS YADIRA VAZQUEZ MORALES
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Credential |
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Telephone | 787-925-2515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | NULL
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