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Organization

CENTRO PSICOLOGICO ILO SE LLC

Active
Parent organization
CENTRO PSICOLOGICO ILO, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRO PSICOLOGICO ILO, INC.
Authorized official
IVELISSE LOPEZ PSYD (PRESIDENT)
(787) 930-3144
Entity
Organization

Contact information

Practice address
66B JOSEFINA LEGRAND, ESQUINA PALMER, CANOVANAS, PR 00729-0000
(787) 903-9863
Mailing address
SAN ALFONSO, D12 CALLE MIS AMORES, CAGUAS, PR 00725-5128
(787) 558-8718

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
08/08/2023
Last updated
04/08/2025
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