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General NPI Number Information
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NPI Number | 1861743635
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Entity Type | Individual
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Provider Name | YASHIRA MARY BRITO M.A
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Gender | Female
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 1122 CALLE L URB. MUNOZ RIVERA
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City | GUAYNABO
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State | PR
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Zip | 00969-3556
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Country | US
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Telephone | 787-380-5721
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 767
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City | BAYAMON
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State | PR
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Zip | 00960-0767
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Country | US
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Telephone | 787-380-5721
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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 | 4239
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License Number State | PR
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