Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3358 | PR |
NPI | 1073743274 |
---|---|
Provider Name | Mrs. Aleida Caceres |
First Address | Humacao, PR 00791 |
Second Address | Humacao, PR 00791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2009 |
Last Update Date | 22/07/2009 |