Organization
INNOVATION MENTAL HEALTH SERVICES CORP
Active
Organization
INNOVATION MENTAL HEALTH SERVICES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR M GONZALEZ PSYD (CLINICAL PSYCHOLOGIST)
(787) 664-1101
Entity
Organization
Contact information
Practice address
5 CALLE, REPARTO MONTELLANO, CAYEY, PR 00736-4201
(787) 664-1101
Mailing address
5 CALLE, REPARTO MONTELLANO, CAYEY, PR 00736
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
2465
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103TH0100X
—
PR
Enumeration date
05/26/2015
Last updated
04/15/2016
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