Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1586 | PR |
NPI | 1114071263 |
---|---|
Provider Name | Dr. Carlos Rafael Valcarcel |
First Address | San Juan, PR 00924 |
Second Address | San Juan, PR 00924 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 17/04/2008 |