Provider Demographics
NPI:1639501406
Name:EMV SERVICIOS PSICOLOGICOS
Entity Type:Organization
Organization Name:EMV SERVICIOS PSICOLOGICOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:JANICE
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-638-8267
Mailing Address - Street 1:V9 12TH STREET
Mailing Address - Street 2:ALTURAS DE FLAMBOYAN
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-638-8267
Mailing Address - Fax:787-854-0030
Practice Address - Street 1:PLAZA PUERTA DEL SOL CALLE MIGUEL OTERO
Practice Address - Street 2:202 SUITE 101
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:939-630-5720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3384261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health