Provider Demographics
NPI:1083023774
Name:HAPPY BRAINS PSYCHOLOGY, THERAPY & LEARNING CENTER CORP.
Entity Type:Organization
Organization Name:HAPPY BRAINS PSYCHOLOGY, THERAPY & LEARNING CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NILMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS FRADERA
Authorized Official - Suffix:
Authorized Official - Credentials:LCDA
Authorized Official - Phone:787-598-7631
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BK 10 AVENIDA LAS AMERICAS
Practice Address - Street 2:URBANIZACION BAIROA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-900-3983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty