Individual
MRS. MARY NELLY DIAZ GASCOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CONSEJERA
Contact information
Practice address
G33 CALLE 4, TOA ALTA, PR 00953-3571
(787) 215-6703
Mailing address
G33 CALLE 4, TOA ALTA, PR 00953-3571
(787) 215-6703
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1574
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1574
LICENCIA
PR
Enumeration date
09/01/2019
Last updated
09/01/2019
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