Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103TS0200X | School Psychologist | 4706 | PR |
NPI | 1053861153 |
---|---|
Provider Name | Amarillis Molina-Maysonet |
First Address | Barceloneta, PR 00617-1607 |
Second Address | Barceloneta, PR 00617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2016 |
Last Update Date | 19/11/2018 |