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General NPI Number Information
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NPI Number | 1578071049
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Entity Type | Individual
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Provider Name | SHEILA AMARILYS PAGAN NIEVES PHD
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Gender | Female
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 130 CALLE GEORGETTI
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City | NARANJITO
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State | PR
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Zip | 00719-3012
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Country | US
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Telephone | 787-869-7213
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 549
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City | NARANJITO
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State | PR
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Zip | 00719-0549
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Country | US
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Telephone | 787-368-3004
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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 | 5972
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License Number State | PR
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