Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6160 | PR |
NPI | 1093286213 |
---|---|
Provider Name | Veronica Crespo Cruz |
First Address | Humacao, PR 00791-4506 |
Second Address | Humacao, PR 00791-4349 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2018 |
Last Update Date | 16/12/2018 |