Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 5994 | PR |
NPI | 1083127708 |
---|---|
Provider Name | Odalys Milagros Ramos |
First Address | Gurabo, PR 00778 |
Second Address | Caguas, PR 00725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2017 |
Last Update Date | 09/04/2020 |