Provider Demographics
NPI:1871333898
Name:GOYTIA, MAYLIN D (MPSYC)
Entity type:Individual
Prefix:
First Name:MAYLIN
Middle Name:D
Last Name:GOYTIA
Suffix:
Gender:F
Credentials:MPSYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. LIRIOS CALA
Mailing Address - Street 2:205 SAN IGNACIO
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777
Mailing Address - Country:US
Mailing Address - Phone:787-458-0057
Mailing Address - Fax:
Practice Address - Street 1:URB. LIRIOS CALA
Practice Address - Street 2:205 SAN IGNACIO
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-458-0057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7548103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling