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Organization

CENTRO PSICOLOGICO ILO, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IVELISSE LOPEZ PSYD (PRESIDENTE)
(787) 930-3144
Entity
Organization

Contact information

Practice address
SAN ALFONSO D12 CALLE MIS AMORES, CAGUAS, PR 00725-5821
(787) 930-3144
Mailing address
CALLE RUBI VILLA BLANCA #31, CAGUAS, PR 00725-1933
(787) 672-8096

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1041C0700X
Clinical Social Worker
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
08/12/2013
Last updated
04/02/2025
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