Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6146 | PR |
Y | 103TC1900X | Counseling Psychologist | 6146 | PR |
NPI | 1225627292 |
---|---|
Provider Name | Dr. Deborah Grace Tirado-Class |
First Address | Catano, PR 00962-4519 |
Second Address | San Juan, PR 00926-5435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2021 |
Last Update Date | 14/01/2021 |