Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | 4215 | PR |
N | 103TM1800X | Intellectual & Developmental Disabilities | 4215 | PR |
N | 103TP0814X | Psychoanalysis | 4215 | PR |
N | 103TP2701X | Group Psychotherapist | 4215 | PR |
Y | 103TS0200X | School Psychologist | 4215 | PR |
NPI | 1053661330 |
---|---|
Provider Name | Mrs. Carmen Yamaril Torres Cintron |
First Address | Utuado, PR 00641 |
Second Address | Utuado, PR 00641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2012 |
Last Update Date | 14/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17 | SERVICES PSICOLOGY (01) | PR |
37 | SERVICES PSICOLOGY (01) | PR |
39 | (05) | PR |