Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 7040 | PR |
NPI | 1003588773 |
---|---|
Provider Name | Dr. Jonaida Otero |
First Address | Juncos, PR 00777 |
Second Address | Juncos, PR 00777-3636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2021 |
Last Update Date | 19/01/2022 |