Organization
INNOVA PSYCHOLOGICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN A GONZALEZ RIVERA PSY.D. (ADMINISTRATOR)
(939) 545-5241
Entity
Organization
Contact information
Practice address
CARR 695 KM 2.0, BO HIGUILLAR, DORADO, PR 00646
(787) 315-6034
Mailing address
500 AVE WEST MAIN APT 215, BAYAMON, PR 00961-3875
(787) 315-6034
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
05/08/2019
Last updated
05/20/2021
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