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General NPI Number Information
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NPI Number | 1912697046
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Entity Type | Organization
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Legal Business Name | CLINICA PSICOTERAPEUTICA INTEGRAL COGNOSIS
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | EDIFICIO PROFESIONAL DE SANTA ISABEL SUITE 101 CARR 153 KM 7.5 BARRIO USERAS
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-579-4370
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Fax |
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Provider Business Mailing Address
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Address Line | URB. ESTANCIAS DE SANTA ISABEL 115 CALLE AMATISTA
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-579-4370
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MR. EDWIN I VAZQUEZ
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Credential | CSW
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Telephone | 787-579-4370
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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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