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General NPI Number Information
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NPI Number | 1699235408
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Entity Type | Organization
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Legal Business Name | POWERFULL MINDS COACH II INC
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | CARR PR 417 KM 0.5 AVE NATIVO ALERS DESVIO SUR BO ASOMANTE
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 939-319-9417
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Fax |
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Provider Business Mailing Address
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Address Line | HC 57 BOX 9417
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City | AGUADA
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State | PR
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Zip | 00602-9828
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER JIMENEZ
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Credential |
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Telephone | 787-546-7930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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