Provider Demographics
NPI:1477763928
Name:LOYOLA, MONICA M (OTL)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:M
Last Name:LOYOLA
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:F27 CALLE VILLA TULIPAN
Mailing Address - Street 2:URB EL PLANTIO
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4443
Mailing Address - Country:US
Mailing Address - Phone:787-459-7554
Mailing Address - Fax:
Practice Address - Street 1:VILLA TULIPAN F27
Practice Address - Street 2:URB EL PLANTIO
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-459-7554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1001225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist