Provider Demographics
NPI:1073716767
Name:ARISMENDI, KEILA CRISTINA
Entity Type:Individual
Prefix:MS
First Name:KEILA
Middle Name:CRISTINA
Last Name:ARISMENDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JB20 CALLE 242
Mailing Address - Street 2:COUNTRY CLUB 3 EXTENTION
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-2779
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 4258
Practice Address - Street 2:BAYAMON GARDENS STATION
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00958-1258
Practice Address - Country:US
Practice Address - Phone:787-786-1012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1941103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling