Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 2345 | PR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 2345 | PR |
Y | 103G00000X | Clinical Psychologist | 2345 | PR |
Y | 103TC0700X | Clinical Psychologist | 2345 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2345 | PR |
N | 103TF0000X | Family Psychologist | 2345 | PR |
N | 103TH0100X | Health Service | 2345 | PR |
N | 103TP2701X | Group Psychotherapist | 2345 | PR |
N | 103TS0200X | School Psychologist | 2345 | PR |
NPI | 1134383953 |
---|---|
Provider Name | Dr. Dalila Nieves-Serrano |
First Address | Lares, PR 00669-0011 |
Second Address | Lares, PR 00669-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 10/07/2008 |