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General NPI Number Information
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NPI Number | 1336875160
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Entity Type | Organization
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Legal Business Name | CENTRO TERAPEUTICO FAMILIAR, LLC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | CARR 8860 KM 1.5 PLAZA MATIENZO SHOPPING CENTER EDIF. A 2ND FLOOR SUITE #3
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City | TRUJILLO ALTO
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State | PR
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Zip | 00977
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Country | US
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Telephone | 939-326-1888
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Fax |
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Provider Business Mailing Address
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Address Line | 13-A O-708 URB ALTURAS
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | US
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Telephone | 939-326-1888
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Fax |
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Authorized Official
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Title or Position | SLP, OWNER
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Name | LEISHLY M NIEVES-FERRER
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Credential | SLP
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Telephone | 939-326-1888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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