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General NPI Number Information
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NPI Number | 1932920568
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Entity Type | Organization
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Legal Business Name | SM PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 77 CALLE TORRE APT C
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City | PONCE
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State | PR
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Zip | 00730-3815
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Country | US
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Telephone | 787-710-6720
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Fax |
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Provider Business Mailing Address
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Address Line | URB VILLA DEL CARMEN CALLE SENTINA 872
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-710-6720
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZULMAIRIM SANTOS MERCADOS
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Credential | PSYD
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Telephone | 787-710-6720
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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 |
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