Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1215287487 |
---|---|
Provider Name | Miss Yahaira M. Patin-Betancourt |
First Address | Los Angeles, CA 90026-4915 |
Second Address | San Juan, PR 00921-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2012 |
Last Update Date | 11/02/2019 |