Individual
ELITZIA J DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDA.
Contact information
Practice address
URB. INDUSTRIAL LAS FLORES CARR. 3 KM 23.9, RIO GRANDE, PR 00721
(787) 704-0705
(787) 751-3755
Mailing address
HC 67 BOX 18195, FAJARDO, PR 00738-9432
(214) 791-3635
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3092
PR
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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