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NPI 1497285456

NPI 1497285456 : WANDALIS APONTE MA : AGUADA, PR

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General NPI Number Information
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    NPI Number           |    1497285456
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    Entity Type          |    Individual 
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    Provider Name        |    WANDALIS APONTE MA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/13/2017
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    Last Update Date     |    06/13/2017
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Provider Practice Location Address
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    Address Line         |    CARR 2 KM 133.5 EDIFICIO CENTERPLEX SUITE 307
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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            |    939-254-6058
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9432 BALBINO TRINTA URB. RIO CRISTAL
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    City                 |    MAYAGUEZ
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    State                |    PR
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    Zip                  |    00680
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    Country              |    US
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    Telephone            |    939-254-6058
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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       |    5759
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    License Number State |    PR
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