Provider Demographics
NPI:1316994379
Name:DE JESUS, DEMY A (PH D)
Entity type:Individual
Prefix:MR
First Name:DEMY
Middle Name:A
Last Name:DE JESUS
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Gender:M
Credentials:PH D
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Mailing Address - Street 1:PO BOX 71474
Mailing Address - Street 2:APS CLINICS OF PR INC
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8574
Mailing Address - Country:US
Mailing Address - Phone:787-641-0774
Mailing Address - Fax:707-641-2759
Practice Address - Street 1:SITOS LISINDA NATIONAL
Practice Address - Street 2:VICTORY SHOPPING CENTER APS CLINICS OF PR INC BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:787-641-2759
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR2478103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical