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General NPI Number Information
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NPI Number | 1326849035
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Entity Type | Individual
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Provider Name | KRYSTAL HERNANDEZ BURGOS
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Gender |
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 65 CALLE CABRERA, ESQUINA ANTONIO LOPEZ,HUMACAO PUEBLO 65C11 LA CARRERA
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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 | 939-275-3834
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Fax |
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Provider Business Mailing Address
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Address Line | 133 COMUNIDAD ASOMANTE # 11
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-9448
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Country | US
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Telephone | 939-275-3834
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 7551
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License Number State | PR
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