Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2942 | PR |
Y | 103TC0700X | Clinical Psychologist | 2942 | PR |
NPI | 1003085622 |
---|---|
Provider Name | Maria De Los A Burgos Carrion |
First Address | Catano, PR 00962-4269 |
Second Address | Catano, PR 00962-4269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2008 |
Last Update Date | 28/08/2014 |