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General NPI Number Information
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NPI Number | 1437575560
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Entity Type | Individual
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Provider Name | NIVLEM CAPPA PH. D.
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Gender | Female
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 79 CALLE PONCE URB PEREZ MORRIS
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City | SAN JUAN
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State | PR
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Zip | 00917-5007
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Country | US
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Telephone | 787-209-9568
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Fax |
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Provider Business Mailing Address
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Address Line | URB PEREZ MORRIS 79 PONCE STREET
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City | SAN JUAN
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State | PR
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Zip | 00917-5007
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Country | US
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Telephone | 787-209-9568
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 005219
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License Number State | PR
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