Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 5469 | PR |
NPI | 1063754851 |
---|---|
Provider Name | Mrs. Yaritza Enid Irizarry |
First Address | Arecibo, PR 00613 |
Second Address | Arecibo, PR 00613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2013 |
Last Update Date | 07/03/2014 |