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General NPI Number Information
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NPI Number | 1497392302
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Entity Type | Organization
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Legal Business Name | ESTIMULACION COGNITIVA DEL OESTE LLC
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 07/17/2022
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Provider Practice Location Address
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Address Line | 67 CALLE DR RAMON E BETANCES S
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4071
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Country | US
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Telephone | 787-515-4657
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Fax |
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Provider Business Mailing Address
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Address Line | 67 CALLE DR RAMON E BETANCES S
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4071
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS LIARA MARTINEZ MOLINA
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Credential |
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Telephone | 787-515-4657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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