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Organization
PSICODRAMA PR CP
Active
Organization
PSICODRAMA PR CP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANNESSA PAGAN MD (PRESIDENT)
17874005436
Entity
Organization
Contact information
Practice address
CARR 2 KM 156.5, 510 AVE HOSTOS VISTA VERDE PLAZA SUITE A-12A, MAYAGUEZ, PR 00681
(788) 975-2710
Mailing address
7 LAS CASONAS, AGUADA, PR 00602-9221
(787) 975-2710
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
14054
PR
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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