Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6089 | PR |
NPI | 1053807735 |
---|---|
Provider Name | Miss Ashley M Miranda Sierra |
First Address | Florida, PR 00650-9346 |
Second Address | Florida, PR 00650 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2018 |
Last Update Date | 06/07/2018 |