MEDICARE: OSMARY OLIVENCIA SANCHEZ PSY.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2772	PR

General Provider Information

NPI Number	:	1932250925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSMARY OLIVENCIA SANCHEZ PSY.D

Provider Business Mailing Address
First Line	:	434 CARR 342
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-7604
Country	:	US
Telephone Number	:	787-464-6186
Fax Number	:

Provider Business Practice Location Address
First Line	:	2162 BLVD LUIS.A .FERRE
Second Line	:	URB.VILLA GRILLASCA
City	:	PONCE
State	:	PR
Zip	:	00717-0722
Country	:	US
Telephone Number	:	787-840-1110
Fax Number	:	787-840-0003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/23/2021

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