Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 2469 | PR |
NPI | 1053521930 |
---|---|
Provider Name | Miss Astrid Aquino |
First Address | Bayamon, PR 00956-2908 |
Second Address | Bayamon, PR 00956-2841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |