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Individual

MARISOL LUNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
TAC-III, TFC-III

Contact information

Practice address
COMUNIDAD WILLIAM FUERTES, CALLE 3 P73 B BO PALMAS, CATANO, PR 00962
(787) 462-1101
Mailing address
HC 46 BOX 5560, DORADO, PR 00646-9611
(787) 462-1101

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
05-20-2057
FL
101YP2500X
Professional Counselor
Primary
07-39-2057
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TAC-III-05-20-2057
IRBO CORP.
FL
01
TFC-III-07-39-2057
IRBO CORP
FL
Enumeration date
05/13/2021
Last updated
05/13/2021
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