Evian L Albert

Individual provider Active NPI Speech-Language Pathologist · Ponce, PR

NPI 1780910588 · NPPES record last updated Feb 15, 2022

Key facts

NPI
1780910588
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
4253 (PR)
Practice address
Urb. Constancia
B-46 Paseo Las Colonias , Ste. 1811
Ponce, PR 00717
Phone
(939) 213-6064
NPI assigned
Oct 29, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4253PRMDClinical Psychologist
1060PRMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X 4253 PR Yes
Speech-Language Assistant 2355S0801X 1060 PR

Addresses

Primary practice location

Urb. Constancia
B-46 Paseo Las Colonias , Ste. 1811
Ponce, PR 00717

Mailing address

105 Calle Florencio
Juana Diaz, PR 00795-9245
Phone (787) 259-0896

Other providers in Ponce, PR

All providers in Ponce, PR · Speech-Language Pathologist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.