Individual
DR. FERSSEN ELIASIN MUNOZ MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DOCTOR IN PSYCHOLOGY
Contact information
Practice address
388 ZONA IND REPARADA 2, PONCE, PR 00716-2347
(787) 812-2525
Mailing address
GRAN VISTA 1, CALLE EL PRADO #66, GURABO, PR 00778
(787) 633-3656
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7031
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
PR
Other
Enumeration date
10/26/2018
Last updated
12/27/2021
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