Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1984 | PR |
N | 103T00000X | Psychologist | 1984 | PR |
N | 103TA0700X | Adult Development & Aging Psychologist | 1984 | PR |
N | 103G00000X | Clinical Psychologist | 1984 | PR |
N | 103TC0700X | Clinical Psychologist | 1984 | PR |
Y | 103TC1900X | Counseling Psychologist | 1984 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1984 | PR |
N | 103TF0000X | Family Psychologist | 1984 | PR |
N | 103TF0200X | Forensic Psychologist | 1984 | PR |
NPI | 1831133305 |
---|---|
Provider Name | Dr. Rafael E Cancio |
First Address | San Juan, PR 00921-3200 |
Second Address | San Juan, PR 00921-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 20/09/2021 |