Provider Demographics
NPI:1811574361
Name:GONZALEZ ADAMES, IVETTE ARELIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:IVETTE
Middle Name:ARELIS
Last Name:GONZALEZ ADAMES
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:HC 5 BOX 54970
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9702
Mailing Address - Country:US
Mailing Address - Phone:787-201-1136
Mailing Address - Fax:
Practice Address - Street 1:ROBERTO CLEMENTE I
Practice Address - Street 2:CALLE C CASA 248
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-0065
Practice Address - Country:US
Practice Address - Phone:787-201-1136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6785103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical