Provider Demographics
NPI:1013339654
Name:COSS LOPEZ, VENUS (PSY D)
Entity Type:Individual
Prefix:DR
First Name:VENUS
Middle Name:
Last Name:COSS LOPEZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 CALLE COAMO
Mailing Address - Street 2:BONNEVILLE HEIGHTS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-4931
Mailing Address - Country:US
Mailing Address - Phone:787-462-9344
Mailing Address - Fax:
Practice Address - Street 1:BONNEVILLE HEIGHTS CALLE COAMO #62
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00727
Practice Address - Country:SH
Practice Address - Phone:787-462-9344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-16
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5420103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical