Organization
SUI GENERIS CLINICA DE SERVICIOS PSICOLOGICOS P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANGELA M TABOAS (PRESIDENT)
(787) 613-1744
Entity
Organization
Contact information
Practice address
47 CALLE MUNOZ RIVERA, TOAL ALTA, PR 00953
(939) 338-1984
Mailing address
47 CALLE MUNOZ RIVERA, TOAL ALTA, PR 00953
(939) 338-1984
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3962
PR
235Z00000X
Speech-Language Pathologist
3001
PR
364SX0106X
Occupational Health Clinical Nurse Specialist
500
PR
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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