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General NPI Number Information
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NPI Number | 1194206169
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Entity Type | Organization
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Legal Business Name | CLINICA DE TERAPIA TIC TALK TOE LLC
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 46 CALLE RAFAEL ROSARIO ARROYO URB EL RECREO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-373-8883
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Fax |
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Provider Business Mailing Address
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Address Line | 46 CALLE RAFAEL ROSARIO ARROYO URB. EL RECREO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-373-8883
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LIZETTE RAMOS
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Credential |
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Telephone | 787-373-8883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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