Individual
MRS. DIANA TERESA DOMENECH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSIC
Contact information
Practice address
MO17 PASEO DEL VALLE, BAYAMON, PR 00961-3539
(787) 467-8878
Mailing address
MO17 PASEO DEL VALLE, BAYAMON, PR 00961-3539
(787) 467-8878
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
5920
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5920
PSIC NUMBER
PR
Enumeration date
01/11/2018
Last updated
01/11/2018
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