Provider Demographics
NPI:1588497853
Name:PR TRAUMA HEALING INSTITUTE, PSC
Entity type:Organization
Organization Name:PR TRAUMA HEALING INSTITUTE, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ISA
Authorized Official - Middle Name:I
Authorized Official - Last Name:VELEZ ECHEVARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:939-788-2423
Mailing Address - Street 1:URB CAGUAX C-8 AVE LUIS MUNOZ MARIN
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3364
Mailing Address - Country:US
Mailing Address - Phone:939-788-2423
Mailing Address - Fax:
Practice Address - Street 1:URB CAGUAX AVE LUIS MUNOZ MARIN C-8
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-800-1660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)