Provider Demographics
| NPI: | 1073387692 |
|---|---|
| Name: | CENTRO DE TERAPIA DANDO ALAS CORP. |
| Entity Type: | Organization |
| Organization Name: | CENTRO DE TERAPIA DANDO ALAS CORP. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SPEECH LANGUAGE PATHOLOGIST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ALEXANDRA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MOLL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 787-403-6583 |
| Mailing Address - Street 1: | 1589 CALLE ATUN |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CAROLINA |
| Mailing Address - State: | PR |
| Mailing Address - Zip Code: | 00983-1456 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | CAMPO RICO OFFICE PLAZA ST 103 |
| Practice Address - Street 2: | AVE. ROBERTO SANCHEZ VILELLA |
| Practice Address - City: | CAROLINA |
| Practice Address - State: | PR |
| Practice Address - Zip Code: | 00983 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 787-403-6583 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-11-14 |
| Last Update Date: | 2023-11-14 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 224ZE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Environmental Modification | Group - Multi-Specialty |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification | Group - Multi-Specialty |
| No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | Group - Multi-Specialty |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
