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General NPI Number Information
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NPI Number | 1285427278
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL CONSULTING PSYCHOEDUCATIONAL SERVICE LLC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 1000 AVE PONCE DE LEON SUITE 500 EDIFICIO TELESFORO ESQ CERRA
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-764-2665
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Fax |
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Provider Business Mailing Address
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Address Line | 405 AVE ESMERALDA STE 2
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City | GUAYNABO
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State | PR
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Zip | 00969-4466
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Country | US
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Telephone | 787-644-9872
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERTO DE JESUS
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Credential | PH. D
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Telephone | 787-644-9872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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