Provider Demographics
NPI:1881935914
Name:PSICOTRANSFORMACION,C.S.P.
Entity type:Organization
Organization Name:PSICOTRANSFORMACION,C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSICOLOGA
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-477-8406
Mailing Address - Street 1:HC 20 BOX 26307
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754
Mailing Address - Country:US
Mailing Address - Phone:787-477-8406
Mailing Address - Fax:787-746-8079
Practice Address - Street 1:HC 20 BOX 26307
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754-9653
Practice Address - Country:US
Practice Address - Phone:787-477-8406
Practice Address - Fax:787-746-8079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3111103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1184905721OtherNPI