Individual
JOSE EFRAIN RODRIGUEZ AGOSTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
31 CALLE 1, URB. MONTECIELO, GUAYNABO, PR 00970
(787) 307-9339
Mailing address
PO BOX 3327, GUAYNABO, PR 00970-3327
(787) 307-9339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6695
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6695
PSYCHOLOGIST
PR
Enumeration date
04/26/2021
Last updated
04/26/2021
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