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General NPI Number Information
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NPI Number | 1831678713
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Entity Type | Individual
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Provider Name | JOHVANNETTE M. EVERTSZ MOLINA PSY.D
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Gender | Female
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Dates
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Enumeration Date | 08/10/2018
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | CARR #2 KM 141.5
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-543-9620
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Fax |
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Provider Business Mailing Address
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Address Line | HC 8 BOX 44693
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City | AGUADILLA
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State | PR
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Zip | 00603-9722
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Country | US
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Telephone | 787-543-9620
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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 | 6641
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License Number State | PR
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