Individual
MISS LILLIAM DIAZ GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
AVE HOSTOS, ESQ. CAMPECHE #1274, PONCE, PR 00732
(787) 767-6710
(787) 758-0950
Mailing address
ARIZONA 7 CASA #11, ARROYO, PR 00714
(787) 204-4342
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
854
PR
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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