Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4298 | PR |
NPI | 1023514320 |
---|---|
Provider Name | Fernando Rafael Ramos-Rosa |
First Address | San Juan, PR 00916-4444 |
Second Address | San Juan, PR 00918-3532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2018 |
Last Update Date | 04/04/2018 |