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General NPI Number Information
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NPI Number | 1033663224
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Entity Type | Individual
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Provider Name | DORIS M FELICIANO VEGA M.SC., PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | HC 60 BOX 15345
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City | AGUADA
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State | PR
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Zip | 00602-9274
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Country | US
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Telephone | 787-567-7259
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Fax |
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Provider Business Mailing Address
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Address Line | HC 60 BOX 15345
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City | AGUADA
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State | PR
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Zip | 00602-9274
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Country | US
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Telephone | 787-567-7259
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5665
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License Number State | PR
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