Provider Demographics
NPI:1114779873
Name:PSICOLOGIA AMOR & ARTE LLC
Entity Type:Organization
Organization Name:PSICOLOGIA AMOR & ARTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWER/ DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUZ YIRAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-957-6607
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-368-4614
Mailing Address - Fax:
Practice Address - Street 1:PASEO SAN ISIDRO SUITE #2
Practice Address - Street 2:CARR.188 KM 2.0 ESQUINA C/6 Y C6A
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-0697
Practice Address - Country:US
Practice Address - Phone:787-957-6608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty