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General NPI Number Information
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NPI Number | 1679394969
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Entity Type | Organization
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Legal Business Name | ONIRIC PSYCHOLOGY STUDIO
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | CENTRO ISABELINO DE MEDICINA AVANZADA (CIMA) SUITE 11
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 939-254-0727
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Fax |
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Provider Business Mailing Address
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Address Line | HC 3 BOX 8349
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City | LARES
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State | PR
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Zip | 00669-9573
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Country | US
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Telephone | 939-254-0727
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MR. JORGE A PEREZ AROCHO
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Credential | MA
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Telephone | 787-356-6130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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