NPI | 1720739899 |
---|---|
Professional Name | JELISSE MATOS RENTA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 6671) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PR 6671) |
103TS0200X Psychologist, School (Licence: PR 6671) | |
Enumeration Date | 2022-01-11 |
Last Update Date | 2025-08-20 |