| Centro Psicologico Ilo Se Llc | |
|
66b Josefina Legrand Esquina Palmer Canovanas PR 00729-0000 | |
| (787) 903-9863 | |
| Not Available |
| Full Name | Centro Psicologico Ilo Se Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 66b Josefina Legrand, Canovanas, Puerto Rico |
| Authorized Official Name and Position | Ivelisse Lopez Lopez (PROPIETARIO) |
| Authorized Official Contact | 7876728096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Psicologico Ilo Se Llc San Alfonso D12 Calle Mis Amores Caguas PR 00725-5128 Ph: (787) 558-8718 | Centro Psicologico Ilo Se Llc 66b Josefina Legrand Esquina Palmer Canovanas PR 00729-0000 Ph: (787) 903-9863 |
| NPI Number | 1427731538 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427731538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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