Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013190008 |
---|---|
Provider Name | Mrs. Vimari Vega Rios |
First Address | Trujillo Alto, PR 00976-3424 |
Second Address | Bayamon, PR 00961 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2007 |
Last Update Date | 06/09/2011 |