Individual
JOHANNIE GONZALEZ VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDA
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1471
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1471
NUTRITIONIST / DIETIST
PR
Enumeration date
12/03/2019
Last updated
12/03/2019
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