Organization
PRAXIS CPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANGELICA DE JESUS MS/SLP (OWNER)
(787) 202-4611
Entity
Organization
Contact information
Practice address
3B CALLE ABANICO, URB APONTE, SAN LORENZO, PR 00754
(787) 202-4611
Mailing address
PO BOX 11998, CIDRA, PR 00739-1998
(787) 202-4611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
887
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487982781
SPEECH LANGUAGE PATHOLIGIST
PR
Enumeration date
03/09/2015
Last updated
03/09/2015
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