Provider Demographics
NPI:1417175217
Name:INSTITUTO PSICOLOGICO Y EDUCATIVO DEL NORTE
Entity Type:Organization
Organization Name:INSTITUTO PSICOLOGICO Y EDUCATIVO DEL NORTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-447-6227
Mailing Address - Street 1:544 CALLE TRUNCADO
Mailing Address - Street 2:BARRIO CARRIZALES
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-2712
Mailing Address - Country:US
Mailing Address - Phone:787-447-6227
Mailing Address - Fax:
Practice Address - Street 1:544 CALLE TRUNCADO
Practice Address - Street 2:BARRIO CARRIZALES
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-2712
Practice Address - Country:US
Practice Address - Phone:787-447-6227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2600261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)