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General NPI Number Information
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NPI Number | 1730655317
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Entity Type | Organization
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Legal Business Name | OLIVIA TORRES PSYD, PLLC
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Dates
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Enumeration Date | 10/22/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 833 KENMOOR AVE SE STE A
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2390
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Country | US
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Telephone | 309-208-6430
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Fax | 616-965-3968
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Provider Business Mailing Address
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Address Line | 833 KENMOOR AVE SE STE A
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2390
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Country | US
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Telephone | 309-208-6430
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Fax | 616-965-3968
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Authorized Official
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Title or Position | PSYCHOLOGIST RESIDENT
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Name | DR. OLIVIA R TORRES
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Credential | PSYD
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Telephone | 309-208-6430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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