Individual
JEISHA L VICENTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
D81 CALLE C, COSTA DE ORO, DORADO, PR 00646-2012
(787) 796-5900
Mailing address
PO BOX 953, DORADO, PR 00646-0953
(787) 635-1850
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1082
PR
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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