Individual
WANDA MABEL VELEZ DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
CARR 2, KM 122.0, BO CAIMITAL ALTO, AGUADILLA, PR 00603
(939) 312-9233
Mailing address
PO BOX 303, SAN ANTONIO, PR 00690-0303
(939) 312-3566
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1030
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1030
PROFESSIONAL WORK LICENSE
PR
Enumeration date
08/09/2022
Last updated
08/09/2022
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