Individual
LISSETTE HEREDIA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
CARR #2 KM 101.5 BO TERRANOVA, QUEBRADILLAS, PR 00678
(787) 895-7915
(787) 895-7915
Mailing address
HC 02 BOX 8516, QUEBRADILLAS, PR 00678
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1443
PR
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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