Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0700X | Adult Development & Aging Psychologist | 2663 | PR |
NPI | 1649330531 |
---|---|
Provider Name | Dr. Felipe Reyes |
First Address | Arecibo, PR 00613-0571 |
Second Address | Barceloneta, PR 00617-3142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |