Individual
MRS. AMNERIS MEDINA VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
CARR 111 KM 7.1, MOCA, PR 00676
(939) 630-7208
Mailing address
PO BOX 591, MOCA, PR 00676-0591
(939) 630-7208
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6672
PR
103TC1900X
Counseling Psychologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
4391701
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FM1213183-02
FIRST MEDICAL
PR
Enumeration date
07/10/2014
Last updated
01/19/2023
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