Provider Demographics
NPI:1528398542
Name:OTERO, EMILY E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:E
Last Name:OTERO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. LOS ALTOS 181
Mailing Address - Street 2:CIUDAD JARDIN
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-552-7091
Mailing Address - Fax:787-734-6207
Practice Address - Street 1:BAIROA SHOPPING CENTER
Practice Address - Street 2:SUITE 7
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:939-579-8129
Practice Address - Fax:787-734-6207
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3612103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical