Organization
PSYCHOLOGICAL WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIELLY HERNANDEZ FERNANDEZ PHD (CLINICAL PSYCHOLOGY)
(787) 246-2827
Entity
Organization
Contact information
Practice address
CARR.PR-54 INT. RAMAL 7711, BO. POZO HONDO, GUAYAMA, PR 00784
(787) 246-2827
Mailing address
PO BOX 3372, GUAYAMA, PR 00785-3372
(787) 246-2728
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4519251
DRIVER LICENSE
PR
Enumeration date
02/06/2023
Last updated
02/06/2023
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