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General NPI Number Information
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NPI Number | 1801197033
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Entity Type | Organization
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Legal Business Name | INSTITUTO TERAPIA FAMILIAR
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 190 CALLE GAUTIER BENITEZ PLAZA SAN ALFONSO
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City | CAGUAS
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State | PR
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Zip | 00725-5548
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Country | US
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Telephone | 787-746-5756
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Fax | 787-746-3080
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Provider Business Mailing Address
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Address Line | GAUTIER BENITEZ PLAZA SAN ALFONSO PO BOX 861 SUITE 190
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-746-5756
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Fax | 787-746-3080
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ALMA IRIS PAGAN
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Credential | MGO
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Telephone | 787-746-5756
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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 | PR
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