Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 6958 | PR |
Y | 103T00000X | Psychologist | 6958 | PR |
NPI | 1003589425 |
---|---|
Provider Name | Brenda Michelle Anglada Rivera |
First Address | Santa Isabel, PR 00757-0386 |
Second Address | Santa Isabel, PR 00757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2021 |
Last Update Date | 05/08/2021 |