Provider Demographics
NPI:1497157382
Name:VELEZ-ECHEVARRIA, ISA IVETTE (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:ISA
Middle Name:IVETTE
Last Name:VELEZ-ECHEVARRIA
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:PO BOX 331412
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-1412
Mailing Address - Country:US
Mailing Address - Phone:787-901-5497
Mailing Address - Fax:
Practice Address - Street 1:2162 BLVD LUIS A FERRE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0722
Practice Address - Country:US
Practice Address - Phone:787-840-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005890103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty