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General NPI Number Information
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NPI Number | 1750101457
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Entity Type | Organization
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Legal Business Name | PSICOLOGAS DEL OESTE LLC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | CARR 110 KM 24.2
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 939-413-3153
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Fax |
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Provider Business Mailing Address
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Address Line | 3010 CALLE EL PARAISO
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City | ISABELA
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State | PR
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Zip | 00662-6065
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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 | SONIA N RODRIGUEZ RAMOS
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Credential | PSYD
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Telephone | 939-413-3153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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