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General NPI Number Information
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NPI Number | 1093098386
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Entity Type | Individual
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Provider Name | TATIANA MARIE CORTES M.A
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Gender | Female
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | CRR. 110 K.M. 1.2 INT. BO. CERRO GORDO
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-210-6400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 514
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City | ANASCO
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State | PR
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Zip | 00610-0514
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Country | US
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Telephone | 787-210-6400
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2842
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2842
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License Number State | PR
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