Provider Demographics
NPI:1437769254
Name:ACEVEDO, IRMA CRISTINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:CRISTINA
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST. PALMA DE SOMBRERO #2
Mailing Address - Street 2:URB. VILLAS DEL PALMAR SUR
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-207-1161
Mailing Address - Fax:
Practice Address - Street 1:ST. PALMA DE SOMBRERO #2
Practice Address - Street 2:URB. VILLAS DEL PALMAR SUR
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-207-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4666103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical