Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 4346 | PR |
Y | 103TC0700X | Clinical Psychologist | 4346 | PR |
NPI | 1003057571 |
---|---|
Provider Name | Ms. Nilda R Tarafa |
First Address | San Juan, PR 00936-6426 |
Second Address | San Juan, PR 00927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2009 |
Last Update Date | 17/07/2012 |