Provider Demographics
NPI:1063079226
Name:WERNICKE CLINICAL GROUP
Entity type:Organization
Organization Name:WERNICKE CLINICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEGGY
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:SANTIAGO-MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:787-223-7964
Mailing Address - Street 1:141 CALLE NARDO
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-3685
Mailing Address - Country:US
Mailing Address - Phone:787-223-7964
Mailing Address - Fax:
Practice Address - Street 1:URB. SANTA MONICA
Practice Address - Street 2:H-1 CALLE 6 SUITE 103
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-6820
Practice Address - Country:US
Practice Address - Phone:787-223-7964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty