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General NPI Number Information
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NPI Number | 1275396905
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Entity Type | Individual
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Provider Name | CAMILA CRISTAL FELICIANO AVILES PHD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | AVENIDA UNIVERSIDAD INTERAMERICANA SUITE 202
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City | SAN GERMAN
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State | PR
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Zip | 00683-0068
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Country | US
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Telephone | 787-901-8088
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 7895
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City | HORMIGUEROS
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State | PR
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Zip | 00660-9723
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Country | US
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Telephone | 939-284-0888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 007347
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 007347
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License Number State | PR
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