Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 3695 | PR |
NPI | 1023340403 |
---|---|
Provider Name | Mrs. Dianiselle Torres |
First Address | Guaynabo, PR 00969-4280 |
Second Address | Guaynabo, PR 00969-4280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2010 |
Last Update Date | 09/02/2010 |