Provider Demographics
NPI:1437466083
Name:PSYCHE CENTRO DE APOYO PSICOLOGICO INC
Entity Type:Organization
Organization Name:PSYCHE CENTRO DE APOYO PSICOLOGICO INC
Other - Org Name:PSYCHE CENTRO DE APOYO PSICOLOGICO INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZADA-VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-347-5452
Mailing Address - Street 1:HC 04 BOX 46938
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00727
Mailing Address - Country:UM
Mailing Address - Phone:787-347-5452
Mailing Address - Fax:
Practice Address - Street 1:CALLE BETANCES
Practice Address - Street 2:# 23 (BAJOS)
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-961-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2187103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty