Provider Demographics
NPI:1306655394
Name:HEALTH PSYCHOLOGY PR LLC
Entity type:Organization
Organization Name:HEALTH PSYCHOLOGY PR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:RULLAN FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-314-3680
Mailing Address - Street 1:402 BLVD MEDIA LUNA APT 1604
Mailing Address - Street 2:COND. VEREDAS DEL PARQUE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AGUADILLA MEDICAL SERVICES
Practice Address - Street 2:CARR. 2 KM 129.3 SUITE 206
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-4728
Practice Address - Country:US
Practice Address - Phone:787-314-3680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty