Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 4097 | PR |
NPI | 1043697402 |
---|---|
Provider Name | Adamar De Jesus |
First Address | Caguas, PR 00726 |
Second Address | Guaynabo, PR 00969 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2015 |
Last Update Date | 05/05/2015 |