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General NPI Number Information
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NPI Number | 1922488709
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Entity Type | Organization
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Legal Business Name | NEUROPSICOLOGIA INTEGRA LLC
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 73 CALLE SANTA CRUZ SUITE 208
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City | BAYAMON
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State | PR
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Zip | 00961-6910
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Country | US
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Telephone | 787-981-7778
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Fax |
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Provider Business Mailing Address
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Address Line | 425 CARR 693 SUITE 396
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City | DORADO
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State | PR
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Zip | 00646-4816
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Country | US
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Telephone | 787-981-7778
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. RUTH J LOPEZ
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Credential | LIC., M.A.
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Telephone | 787-896-4748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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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 | 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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Taxonomy #3
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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 | 4134
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License Number State | PR
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Taxonomy #5
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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