Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1649 | PR |
NPI | 1063440196 |
---|---|
Provider Name | Mr. Carlos Del Toro Ortiz |
First Address | Carolina, PR 00987-4944 |
Second Address | San Juan, PR 00918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |