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General NPI Number Information
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NPI Number | 1346931706
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Entity Type | Organization
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Legal Business Name | NEUROEDUCATIONAL CONSULTANS LLC
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | BO TIERRA SANTA CARR 149 KM 582 PRIMER PISO
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City | VILLALBA
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State | PR
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Zip | 00766
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Country | US
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Telephone | 787-517-9493
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Fax |
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Provider Business Mailing Address
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Address Line | BO TIERRA SANTA CARR 149 KM 582 PRIMER PISO
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City | VILLALBA
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State | PR
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Zip | 00766
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Country | US
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Telephone | 787-517-9493
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | JOAN MARIE ACOSTA NEGRON
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Credential | PSYCHOLOGIST
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Telephone | 787-517-9493
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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