Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 2607 | PR |
Y | 103T00000X | Psychologist | 2607 | PR |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 2607 | PR |
NPI | 1487902110 |
---|---|
Provider Name | Mr. Angel S Sotero |
First Address | Carolina, PR 00983-0000 |
Second Address | Carolina, PR 00987-1408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2012 |
Last Update Date | 28/08/2012 |