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General NPI Number Information
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NPI Number | 1053861153
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Entity Type | Individual
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Provider Name | AMARILLIS MOLINA-MAYSONET MA PSIC.
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Gender | Female
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | CARR. 140 KM64 H2 CRUCE DAVILA
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City | BARCELONETA
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State | PR
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Zip | 00617
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Country | US
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Telephone | 787-412-5923
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1607
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City | BARCELONETA
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State | PR
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Zip | 00617-1607
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Country | US
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Telephone | 787-412-5923
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 4706
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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