Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 5893 | PR |
Y | 103TC0700X | Clinical Psychologist | 5893 | PR |
NPI | 1003347634 |
---|---|
Provider Name | Dr. Erika Viera Fonseca |
First Address | Dorado, PR 00646-1496 |
Second Address | Vega Alta, PR 00646-9693 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2017 |
Last Update Date | 14/07/2021 |