1861382178 NPI number — KEY THERAPY CLINIC LLC

Table of content: (NPI 1861382178)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861382178 NPI number — KEY THERAPY CLINIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEY THERAPY CLINIC LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1861382178
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB RIVIERA COURT
Provider Second Line Business Mailing Address:
16 CALLE DEUCE
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00959-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BOULEVARD CORNER L1347
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00949-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-449-4092
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARRERO FERNANDEZ
Authorized Official First Name:
YELENNA
Authorized Official Middle Name:
MARIEL
Authorized Official Title or Position:
SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
787-449-4092

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)