Provider Demographics
NPI:1194206169
Name:CLINICA DE TERAPIA TIC TALK TOE LLC
Entity Type:Organization
Organization Name:CLINICA DE TERAPIA TIC TALK TOE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-373-8883
Mailing Address - Street 1:46 CALLE RAFAEL ROSARIO ARROYO
Mailing Address - Street 2:URB. EL RECREO
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-373-8883
Mailing Address - Fax:
Practice Address - Street 1:46 CALLE RAFAEL ROSARIO ARROYO
Practice Address - Street 2:URB EL RECREO
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-373-8883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty