Individual
EMILY ROSA MATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
STATE ROAD 14, CALLE SARGENTO GERARDO SANTIAGO #15, AIBONITO, PR 00705
(787) 714-2462
Mailing address
HC 2 BOX 5772, COMERIO, PR 00782-9667
(787) 925-0254
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6701
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4603788
DRIVER LICENSE
PR
01
—
6701
PROFESSIONAL LICENSE
PR
Enumeration date
10/20/2020
Last updated
11/27/2020
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