Provider Demographics
NPI:1588392385
Name:SERVICIOS OCUPACIONALES Y HABLA DEL LENGUAJE
Entity type:Organization
Organization Name:SERVICIOS OCUPACIONALES Y HABLA DEL LENGUAJE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:939-312-3566
Mailing Address - Street 1:URB SOL Y MAR 488 PASEO DEL MAR
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3870
Mailing Address - Country:US
Mailing Address - Phone:939-312-3566
Mailing Address - Fax:
Practice Address - Street 1:CARR #2, KM 122.0 BO. CAIMITAL ALTO
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:939-312-3566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR915OtherPROFESSIONAL WORK LICENSE