Individual
WANDA I MACHADO ILARRAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
CALLE ANDRES ARUZ RIVERA NUM 153, GURABO, PR 00778
(787) 737-4337
Mailing address
PO BOX 619, GURABO, PR 00778
(787) 435-9398
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2265
PR
Other
Enumeration date
05/03/2010
Last updated
05/03/2010
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