Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 2665 | PR |
NPI | 1124232749 |
---|---|
Provider Name | Mrs. Maria Emilia Malave |
First Address | Salinas, PR 00751 |
Second Address | Salinas, PR 00751-2409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |