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General NPI Number Information
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NPI Number | 1891651204
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Entity Type | Organization
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Legal Business Name | NOVA NEURO PSYCHOLOGY LLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | COND BELAIR # MANGO174
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City | GUAYNABO
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State | PR
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Zip | 00968-4401
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Country | US
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Telephone | 787-349-1589
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Fax |
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Provider Business Mailing Address
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Address Line | COND BELAIR # MANGO174
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City | GUAYNABO
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State | PR
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Zip | 00968-4401
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Country | US
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Telephone | 787-349-1589
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Fax |
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Authorized Official
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Title or Position | PSICOLOGA
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Name | WILMARY RAMOS SOTO
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Credential | LCDA.
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Telephone | 787-349-1589
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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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