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General NPI Number Information
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NPI Number | 1548340482
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Entity Type | Individual
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Provider Name | VICTORIA PEREZ REYES PSY D
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NEW SAN JUAN COMERCIAL LOCAL 4 6471 ISLA VERDE AVE
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City | ISLA VERDE
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State | PR
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Zip | 00979-0000
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Country | US
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Telephone | 787-630-8067
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Fax |
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Provider Business Mailing Address
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Address Line | RIO GRANDE STATES 11406 REY LUIS XV
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City | RIO GRANDE
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State | PR
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Zip | 00745-0000
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Country | US
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Telephone | 787-630-8067
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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 | 1480
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License Number State | PR
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