Provider Demographics
NPI:1699428086
Name:HAPPY BRAINS PSYCHOLOGY PR
Entity type:Organization
Organization Name:HAPPY BRAINS PSYCHOLOGY PR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SICOLOGA
Authorized Official - Prefix:DR
Authorized Official - First Name:NILMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS FRADERA
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:787-900-3983
Mailing Address - Street 1:URB VILLA MARIA CALLE 3 T 17
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-900-3983
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA BLANCA
Practice Address - Street 2:CALLE ACERINA 2
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-900-3983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty