Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6652 | PR |
NPI | 1053919027 |
---|---|
Provider Name | Eyda Yesmin Inigo |
First Address | Mayaguez, PR 00680 |
Second Address | Mayaguez, PR 00680 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2020 |
Last Update Date | 13/10/2020 |