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General NPI Number Information
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NPI Number | 1285514380
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Entity Type | Individual
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Provider Name | KIMBERLY RUIZ MANGUAL MS
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Gender | Female
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | BO. CAIMITAL ALTO CARR #2, KM 121.8 INT
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 787-806-7458
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 975
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City | HORMIGUEROS
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State | PR
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Zip | 00660-0975
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Country | US
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Telephone | 787-806-7458
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 8561
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License Number State | PR
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