Provider Demographics
NPI:1851998959
Name:FELIX FERMIN, JAHAIRA (PHD)
Entity Type:Individual
Prefix:
First Name:JAHAIRA
Middle Name:
Last Name:FELIX FERMIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 CARR 20 VILLA VENECIA 1
Mailing Address - Street 2:APT. 8A-1
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-4018
Mailing Address - Country:US
Mailing Address - Phone:787-226-6810
Mailing Address - Fax:
Practice Address - Street 1:93 CARR 20 VILLA VENECIA 1
Practice Address - Street 2:APT. 8A-1
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-4018
Practice Address - Country:US
Practice Address - Phone:787-226-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5750103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical