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General NPI Number Information
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NPI Number | 1982917969
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Entity Type | Individual
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Provider Name | RICHARD ANTHONY AVILES MICHEL PH.D, ABPDN
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Gender | Male
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 06/26/2017
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Provider Practice Location Address
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Address Line | 1605 AVE. PONCE DE LEON SUITE 111
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-725-0985
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Fax |
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Provider Business Mailing Address
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Address Line | 264 HOWARD STREET UNIVERSITY GARDENS
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-226-4992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0031
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License Number State | PR
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