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Organization

HECTOR J GUERRA

Active
Other names
Clinical Support Group Inc
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALICE RUSCALLEDA PH.D. (CEO)
(787) 768-5501
Entity
Organization

Contact information

Practice address
1432 CALLE BARRACUDA, BAHIA VISTAMAR, CAROLINA, PR 00983-1451
(787) 768-5501
(787) 768-8094
Mailing address
1432 CALLE BARRACUDA, BAHIA VISTAMAR, CAROLINA, PR 00983-1451
(787) 768-5501
(787) 768-8094

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1041C0700X
Clinical Social Worker
9140
PR
225X00000X
Occupational Therapist

Other

Enumeration date
07/14/2006
Last updated
01/15/2009
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