Individual
LYZETTE DINORAH COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
URB. HUYKE 204 CALLE UNION, SAN JUAN, PR 00918
(787) 772-4783
Mailing address
1407 AVE. ASHFORD COND. CONDADO AMBASSADOR, APT. 603, SAN JUAN, PR 00907
(787) 560-5696
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3995
PR
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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