| Organization Name: | EOS: PSYCHOLOGICAL WELLNESS CENTRE |
| NPI Number: | 1003188244 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AGNES SYBEL DIAZ (CLINICAL PSYCHOLOGIST) |
| Mailing Address: | Ave Monserrate Ab 18 Local 4 Valle Arriba Heights Carolina |
| State: | PR US |
| Postal Code: | 00985 |
| Phone Number: | 7875509708 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2012 |
| NPI Last Update Date: | 02/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 4105 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |