Individual
KEISHLA M ESPARRA LUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
6161
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6161
PSICOLOGA
PR
Enumeration date
07/19/2018
Last updated
12/17/2022
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