Provider Demographics
NPI:1669155115
Name:SILVA, LOURDES (PHD)
Entity type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 AVENIDA WALL
Mailing Address - Street 2:TERRAZAS DE TINTILLO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1657
Mailing Address - Country:US
Mailing Address - Phone:787-458-6804
Mailing Address - Fax:
Practice Address - Street 1:CALLE 8 SUITE 10
Practice Address - Street 2:PLAZA CHALETS CAPARRA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-458-6804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2701103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical