Provider Demographics
NPI:1821974247
Name:GARCIA DE QUEVEDO, L
Entity type:Individual
Prefix:
First Name:L
Middle Name:
Last Name:GARCIA DE QUEVEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB BELAIR
Mailing Address - Street 2:146 CALLE QUENEPA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-4027
Mailing Address - Country:US
Mailing Address - Phone:787-528-5580
Mailing Address - Fax:
Practice Address - Street 1:CENTRO DE DIAGNOSTICO PARA INTELIGENCIAS MULTIPLES
Practice Address - Street 2:CALLE VICTORIA 1551
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-722-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2463103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling