Individual
JAN KRISTIAN JOSE SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
CARR. 436 KM 1.2 BO ESPINO CEIBA, LARES, PR 00669
(787) 413-0008
Mailing address
HC 3 BOX 9475, LARES, PR 00669-9572
(787) 413-0008
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
7079
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6128946
—
PR
Enumeration date
09/19/2022
Last updated
09/14/2023
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