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General NPI Number Information
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NPI Number | 1932712247
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Entity Type | Organization
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Legal Business Name | IRS HOLISTIC CENTER L.L.C
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | CALLE SERGIO PENA ALMODOVAR 103
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City | HUMACAO
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State | PR
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Zip | 00791-3655
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Country | US
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Telephone | 787-362-4175
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Fax | 787-767-0210
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Provider Business Mailing Address
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Address Line | 570 URB EXT VILLAS DE BUENA VENTURA
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City | YABUCOA
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State | PR
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Zip | 00767-0000
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Country | US
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Telephone | 787-362-4175
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Fax | 787-767-0210
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Authorized Official
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Title or Position | PROVIDER
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Name | IVONNE YAMIL RODRIGUEZ RAMOS
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Credential |
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Telephone | 787-362-4175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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