Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4269680 | PR |
NPI | 1043496631 |
---|---|
Provider Name | Richard Santos Garcia |
First Address | Juana Diaz, PR 00795-0569 |
Second Address | Juana Diaz, PR 00795 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2008 |
Last Update Date | 28/03/2013 |