Individual
MRS. MARA ITZEL SOTO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDA
Contact information
Practice address
CARR #2 KM 122.5, BO. CAIMITAL ALTO, AGUADILLA, PR 00603
(939) 313-0343
Mailing address
3623 AVE. MILITAR, SUITE 101 PMB 311, ISABELA, PR 00662
(939) 313-0343
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4226
PR
Other
Enumeration date
07/29/2022
Last updated
08/17/2022
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