Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 004133 | PR |
NPI | 1104210806 |
---|---|
Provider Name | Lilibeth Lopez |
First Address | Cayey, PR 00736-9626 |
Second Address | Cayey, PR 00736-9608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2015 |
Last Update Date | 20/03/2015 |