Provider Demographics
NPI:1225347768
Name:CENTRO EPECIALIZADO EN PATOLOGIA Y TERAPIA DEL HABLA-LENGUAJE
Entity Type:Organization
Organization Name:CENTRO EPECIALIZADO EN PATOLOGIA Y TERAPIA DEL HABLA-LENGUAJE
Other - Org Name:CVCEPTHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:
Authorized Official - Credentials:PHL
Authorized Official - Phone:787-385-8525
Mailing Address - Street 1:HILLVIEW 618 PARK STREET
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HILLVIEW 618 PARK STREET
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-385-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty