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General NPI Number Information
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NPI Number | 1679861645
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Entity Type | Organization
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Legal Business Name | PRPSYCCLINICA INTEGRAL DE SERVICIOS PSICOTERAPEUTICOS Y EDUCATIVOS INC
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | HC 60 BOX 29241-10
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City | AGUADA
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State | PR
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Zip | 00602-9233
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Country | US
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Telephone | 787-372-4130
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Fax |
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Provider Business Mailing Address
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Address Line | HC 60 BOX 29241-10
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City | AGUADA
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State | PR
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Zip | 00602-9233
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Country | US
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Telephone | 787-372-4130
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAYDEE LIZ LORENZO
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Credential | PSY'D
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Telephone | 787-372-4130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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