Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | LIC. 65 | PR |
N | 103T00000X | Psychologist | LIC. 65 | PR |
Y | 103G00000X | Clinical Psychologist | LIC.65 | PR |
Y | 103TC0700X | Clinical Psychologist | LIC.65 | PR |
N | 103TF0000X | Family Psychologist | LIC.65 | PR |
NPI | 1003108465 |
---|---|
Provider Name | Dr. Zaida I Garcia-Yili |
First Address | Carolina, PR 00979-6515 |
Second Address | San Juan, PR 00919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2011 |
Last Update Date | 04/05/2011 |