Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 3230 | PR |
Y | 103T00000X | Psychologist | 3230 | PR |
NPI | 1013147164 |
---|---|
Provider Name | Mrs. Vanelsi Garcia Ortiz |
First Address | San Juan, PR 00936-8574 |
Second Address | Caguas, PR 00725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2009 |
Last Update Date | 19/09/2012 |