Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 432 | PR |
Y | 103TC0700X | Clinical Psychologist | 432 | PR |
NPI | 1003954058 |
---|---|
Provider Name | Sandra I Quiles |
First Address | San Juan, PR 00907-1538 |
Second Address | Bayamon, PR 00956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 21/12/2010 |