Organization
PSICOLOGIA AVANZADA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGEL J RIVERA GOMEZ PSY. D. (PRESIDENTE)
(787) 852-9331
Entity
Organization
Contact information
Practice address
CARR 908, CALLE 26 BA4 BO. TEJAS, HUMACAO, PR 00791-4056
(787) 852-9331
(787) 719-4681
Mailing address
AA2 AVE TEJAS, CORREO VILLA PMB 132, HUMACAO, PR 00791-4349
(787) 852-9331
(787) 719-4681
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
3648
PR
Other
Enumeration date
12/03/2015
Last updated
05/08/2017
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