Provider Demographics
NPI:1073934279
Name:CLINICA STEP
Entity Type:Organization
Organization Name:CLINICA STEP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LIZAMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRON MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PSIC
Authorized Official - Phone:787-368-8091
Mailing Address - Street 1:HC 5 BOX 28401
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641
Mailing Address - Country:US
Mailing Address - Phone:787-368-8091
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM. 86.6
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-410-7108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0334103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty