Individual
SANDRA AISSA MATTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
202 B SANTA ROSA MALL OFIC., BAYAMON, PR 00915-3418
(787) 780-6006
Mailing address
489 CALLE WILLIAM JONES, SAN JUAN, PR 00915-3418
(787) 512-0142
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0003
PR
235Z00000X
Speech-Language Pathologist
3
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003
SPEECH-LANGUAGE PATHOLOGIST LICENCE (ORCHP)
PR
01
—
59573
PROFFICE OF REGULATION AND CERTIFICATION OF HELTH PROFFESIONALS
PR
Enumeration date
07/28/2016
Last updated
07/28/2016
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