Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | 981 | PR |
NPI | 1053975235 |
---|---|
Provider Name | Abraham Alexandre Valentin-Vega |
First Address | Mayaguez, PR 00681-1570 |
Second Address | Mayaguez, PR 00680-7042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2019 |
Last Update Date | 23/04/2019 |