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General NPI Number Information
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NPI Number | 1659644250
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Entity Type | Organization
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Legal Business Name | IFDECH
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | BARRIO CONSEJO BAJO CARRETERA 377 INTERIOR
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City | GUAYANILLA
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State | PR
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Zip | 00656-3841
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Country | US
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Telephone | 787-835-0550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 560841
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City | GUAYANILLA
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State | PR
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Zip | 00656-3841
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Country | US
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Telephone | 787-835-0550
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Fax |
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Authorized Official
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Title or Position | CONSEJERO PASTORAL
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Name | DR. JAIME GALARZA SIERRA
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Credential | D. MIN
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Telephone | 787-835-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | TPC-3-15-62-4595
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License Number State | PR
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