Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 741 | PR |
N | 225XP0200X | Occupational Therapist - Pediatrics | 741 | PR |
NPI | 1285953224 |
---|---|
Provider Name | Iveliz Vazquez-Hernandez |
First Address | San Juan, PR 00920-3709 |
Second Address | San Juan, PR 00920-3709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2010 |
Last Update Date | 28/05/2010 |