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General NPI Number Information
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NPI Number | 1497177372
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Entity Type | Organization
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Legal Business Name | SERVICIOS PSICOLOGICOS LLC
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | RIO PIEDRAS HEIGHTS - TINTO ST. 1733
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City | SAN JUAN
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State | PR
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Zip | 00926-0000
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Country | US
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Telephone | 787-622-4433
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Fax | 787-622-4432
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Provider Business Mailing Address
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Address Line | 220 PLAZA WESTERN AUTO STE 101 PMB 400
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-3607
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Country | US
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Telephone | 787-391-0044
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Fax | 787-622-4432
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARACELI PERONA
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Credential | PHD
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Telephone | 787-391-0044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 002079
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License Number State | PR
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