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General NPI Number Information
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NPI Number | 1578288783
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Entity Type | Organization
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Legal Business Name | NEUROEDUCA SERVICIOS TERAPEUTICOS, INC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 1 CALLE PADRE QUINONES
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City | AGUAS BUENAS
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State | PR
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Zip | 00703-3018
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Country | US
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Telephone | 787-557-0658
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 13370
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City | AGUAS BUENAS
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State | PR
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Zip | 00703-9636
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Country | US
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Telephone | 787-557-0658
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Fax |
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Authorized Official
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Title or Position | PRESIENDETA
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Name | MS. KEISHLA DIAZ SANCHEZ
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Credential |
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Telephone | 787-557-0658
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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 |
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License Number State |
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