| Open-mind Psychology Clinic, Llc | |
|
Bo Voladoras Carr 111 Km 11.1 Moca PR 00676 | |
| (787) 941-1692 | |
| Not Available |
| Full Name | Open-mind Psychology Clinic, Llc |
|---|---|
| Speciality | Psychologist |
| Location | Bo Voladoras Carr 111 Km 11.1, Moca, Puerto Rico |
| Authorized Official Name and Position | Grace Marie Soto (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7875145107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open-mind Psychology Clinic, Llc Hc 4 Box 16478 Moca PR 00676-9663 Ph: (787) 514-5107 | Open-mind Psychology Clinic, Llc Bo Voladoras Carr 111 Km 11.1 Moca PR 00676 Ph: (787) 941-1692 |
| NPI Number | 1740971746 |
|---|---|
| Provider Enumeration Date | 05/19/2023 |
| Last Update Date | 05/19/2023 |
| Certification Date | 05/09/2023 |
| Medicare PECOS PAC ID | 9739542895 |
|---|---|
| Medicare Enrollment ID | O20230823001417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740971746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Grace M Soto-lopez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598466328 PECOS PAC ID: 0648633701 Enrollment ID: I20230823003473 |
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