Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1726 | PR |
NPI | 1104140730 |
---|---|
Provider Name | Pilar Marie Pou |
First Address | Dorado, PR 00646 |
Second Address | Dorado, PR 00646-3628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2010 |
Last Update Date | 25/03/2010 |