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General NPI Number Information
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NPI Number | 1174877732
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Entity Type | Organization
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Legal Business Name | CHARIS SPEECH THERAPY
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 16 CALLE AMATISTA URBANIZACION VILLA BLANCA
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City | CAGUAS
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State | PR
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Zip | 00725-1904
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Country | US
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Telephone | 787-220-5423
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Fax |
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Provider Business Mailing Address
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Address Line | BH4 CALLE LA NINA URBANIZACION BAIROA
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City | CAGUAS
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State | PR
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Zip | 00725-1471
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Country | US
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Telephone | 178-722-0542
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Fax |
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Authorized Official
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Title or Position | DIRECTORA
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Name | MRS. MARIA DE LOS ANGELES ANDINO
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Credential |
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Telephone | 787-220-5423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1099
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License Number State | PR
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