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General NPI Number Information
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NPI Number | 1619764495
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Entity Type | Organization
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Legal Business Name | NEURO LAB THERAPY GROUP, LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 825 AVE SAN PATRICIO
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City | SAN JUAN
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State | PR
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Zip | 00921-1311
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Country | US
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Telephone | 787-466-9722
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Fax |
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Provider Business Mailing Address
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Address Line | 825 AVE SAN PATRICIO
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City | SAN JUAN
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State | PR
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Zip | 00921-1311
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Country | US
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Telephone | 787-466-9722
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NATASHA TORRES RIVERA
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Credential | M.S.
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Telephone | 787-466-9722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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