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NPI Code Detail

MEDICARE: DR. DYHALMA NATACHA AVILA-LOPEZ PHD

MEDICARE:  DR. DYHALMA NATACHA AVILA-LOPEZ  PHD
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
1103T00000XPsychologist2160PR

General Provider Information

NPI Number : 1962643676
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DYHALMA NATACHA AVILA-LOPEZ PHD
Provider Business Mailing Address
First Line : QQ19 CALLE ARTEMISA
Second Line : APOLO
City : GUAYNABO
State : PR
Zip : 00969-5018
Country : US
Telephone Number : 787-287-1731
Fax Number :
Provider Business Practice Location Address
First Line : 265 CALLE SIERRA MORENA
Second Line : LA CUMBRE
City : SAN JUAN
State : PR
Zip : 00926-5539
Country : US
Telephone Number : 787-287-1731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2009
Last Update Date : 03/11/2009

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Directions to “ DR. DYHALMA NATACHA AVILA-LOPEZ PHD” Practice Location

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