Provider Demographics
NPI:1962611889
Name:BELAVAL, GILDA S (PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:GILDA
Middle Name:S
Last Name:BELAVAL
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00954-1001
Mailing Address - Country:US
Mailing Address - Phone:787-870-0144
Mailing Address - Fax:
Practice Address - Street 1:165 ROAD KM 10.3 CONTORNO SECTOR
Practice Address - Street 2:LOCAL 2 2ND FLOOR
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-870-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist