Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | 2842 | PR |
Y | 103TS0200X | School Psychologist | 2842 | PR |
NPI | 1093098386 |
---|---|
Provider Name | Mrs. Tatiana Marie Cortes |
First Address | Anasco, PR 00610-0514 |
Second Address | Aguada, PR 00602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2011 |
Last Update Date | 22/09/2011 |