Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 3916 | PR |
NPI | 1104122118 |
---|---|
Provider Name | Mr. Abdin Padilla |
First Address | Aguada, PR 00602-0221 |
Second Address | Aguada, PR 00602-0221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2011 |
Last Update Date | 09/02/2011 |