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Individual
MR. JOSE LUIS DE LA TORRE JR.
Active
Individual
MR. JOSE LUIS DE LA TORRE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
93-0841022
OR
405300000X
Prevention Professional
Primary
93-0841022
OR
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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