| Psicologia Innovadora Del Oeste | |
|
Bo Lavadero Carr #2 Km Hm 165.5 Hormigueros PR 00660 | |
| (939) 865-3515 | |
| Not Available |
| Full Name | Psicologia Innovadora Del Oeste |
|---|---|
| Speciality | Psychologist |
| Location | Bo Lavadero Carr #2 Km Hm 165.5, Hormigueros, Puerto Rico |
| Authorized Official Name and Position | Grisselle M Beauchamp-cortes (OWNER) |
| Authorized Official Contact | 7876732122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psicologia Innovadora Del Oeste Urb Monte Bello 1027 Calle Majestad Hormigueros PR 00660 Ph: (939) 865-3515 | Psicologia Innovadora Del Oeste Bo Lavadero Carr #2 Km Hm 165.5 Hormigueros PR 00660 Ph: (939) 865-3515 |
| NPI Number | 1275305476 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/20/2023 |
| Medicare PECOS PAC ID | 5496106080 |
|---|---|
| Medicare Enrollment ID | O20240108005676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275305476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Grisselle Beauchamp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679145742 PECOS PAC ID: 6305297995 Enrollment ID: I20240108005722 |
Speech R Us Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Plaza Monserrate Ii, Local 5, Hormigueros, PR 00660 Phone: 787-423-2481 Fax: 787-849-5454 |