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Individual

ISAELISSE M. VEGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
3049 CALLE NOVAS, STARLIGHT, PONCE, PR 00717-1476
(787) 473-4451
Mailing address
STARLIGHT 3049 NOVAS, PONCE, PUERTO RICO 00717

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12787
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4683690
PR
Enumeration date
10/28/2015
Last updated
10/28/2015
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