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General NPI Number Information
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NPI Number | 1972320620
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Entity Type | Organization
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Legal Business Name | SVS PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 909 AVE TITO CASTRO STE 712 TORRE MEDICA SAN LUCAS
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City | PONCE
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State | PR
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Zip | 00716-4722
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Country | US
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Telephone | 787-813-0550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 465
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City | MERCEDITA
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State | PR
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Zip | 00715-0465
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Country | US
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Telephone | 787-813-0550
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Fax | 787-844-3003
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Authorized Official
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Title or Position | PRESIDENTE
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Name | SHARON MARIE VAZQUEZ SILVA
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Credential | PHD
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Telephone | 787-813-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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