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General NPI Number Information
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NPI Number | 1215327895
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Entity Type | Organization
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Legal Business Name | CLINICA DE TERAPIA HORIZONTE LLC
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 1262 AVE AMERICO MIRANDA
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City | SAN JUAN
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State | PR
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Zip | 00921-1620
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Country | US
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Telephone | 787-783-3800
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Fax | 787-783-3800
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Provider Business Mailing Address
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Address Line | 1262 AVE AMERICO MIRANDA
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City | SAN JUAN
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State | PR
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Zip | 00921-1620
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Country | US
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Telephone | 787-783-3800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BELMAR RIVERA
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Credential | MS. SLP
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Telephone | 787-783-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 788
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License Number State | PR
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