Provider Demographics
NPI:1821458449
Name:PSICOLOGIA INTEGRAL CLINICA FORENSE DRA. NORMA GOMEZ SOTO CSP
Entity Type:Organization
Organization Name:PSICOLOGIA INTEGRAL CLINICA FORENSE DRA. NORMA GOMEZ SOTO CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRA./PRESIDENTA
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DRA
Authorized Official - Phone:787-479-6244
Mailing Address - Street 1:PO BOX 433
Mailing Address - Street 2:AVENIDA JOSE CELSO BALBOSA 416 BAJOS
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0433
Mailing Address - Country:US
Mailing Address - Phone:787-879-1962
Mailing Address - Fax:
Practice Address - Street 1:416 AVENIDA JOSE CELSO BALBOSA
Practice Address - Street 2:BAJOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-879-1962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty