Provider Demographics
NPI:1023642386
Name:SERVICIOS PSICOLOGICOS Y CONSULTORIA M&M CSP
Entity type:Organization
Organization Name:SERVICIOS PSICOLOGICOS Y CONSULTORIA M&M CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADIANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-526-6394
Mailing Address - Street 1:PO BOX 1268
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-1268
Mailing Address - Country:US
Mailing Address - Phone:787-526-6394
Mailing Address - Fax:
Practice Address - Street 1:URB JARDINES DE BORINQUEN A-1 SUITE 2
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-526-6394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty