Provider Demographics
NPI:1528197704
Name:OFICINA DE AYUDA SICOLOGICA Y SERVICIOS INTEGRADOS
Entity Type:Organization
Organization Name:OFICINA DE AYUDA SICOLOGICA Y SERVICIOS INTEGRADOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SICOLOGA
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JANICE
Authorized Official - Last Name:CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:787-252-6646
Mailing Address - Street 1:PO BOX 4223
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4223
Mailing Address - Country:US
Mailing Address - Phone:787-252-6646
Mailing Address - Fax:787-252-6646
Practice Address - Street 1:CARR 441 BARRIO CARRIZALES KM 2.8
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-252-6646
Practice Address - Fax:787-252-6646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1710103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty