Organization
CLINICA PSICOTERAPEUTICA SISTEMICA E INTEGRATIVA, CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANIS J. DIAZ PSY.D. (PRESIDENTA)
(787) 677-7704
Entity
Organization
Contact information
Practice address
CALLE GUAYAMA #10, BO PUEBLO, SALINAS, PR 00751
(787) 677-7704
Mailing address
PO BOX 414, AGUIRRE, PR 00704-0414
(787) 677-7704
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4104
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366712226
INDIVIDUAL NPI
PR
Enumeration date
03/26/2012
Last updated
10/08/2012
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