| Doctor Name: | MS. VANESSA MARIA PORTILLA |
| NPI Number: | 1043651250 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | 3801 |
| Business Practice Address: | 168 Ave Pedro Albizu Campos Aguadilla, PR - 006035725 |
| Business Phone Number: | 7879972050 |
| Business Fax Number: | |
| Mailing Address: | 119 Bo Bajuras, ISABELA |
| State: | PR |
| Postal Code: | 006622198 |
| Phone Number: | 7876624236 |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2013 |
| NPI Last Update Date: | 07/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 3801 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |