Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6372 | PR |
NPI | 1063045052 |
---|---|
Provider Name | Emanuel Jimenez Del Toro |
First Address | Guaynabo, PR 00966-1686 |
Second Address | San Juan, PR 00918-3746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2020 |
Last Update Date | 13/03/2020 |