Provider Demographics
NPI:1558645507
Name:AHMAD-PEREIRA, YOUSSEF (PHD)
Entity type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:
Last Name:AHMAD-PEREIRA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7032
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-7032
Mailing Address - Country:US
Mailing Address - Phone:787-949-0414
Mailing Address - Fax:
Practice Address - Street 1:CALLE MENDEZ VIGO # 6163
Practice Address - Street 2:ED. TORRE DE HOSTOS OFICINA 1 C
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-949-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3842103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical