Provider Demographics
NPI:1083045538
Name:SANTOS, ROBERT JR
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:SANTOS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 NORRIS RD
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE BEACH
Mailing Address - State:MA
Mailing Address - Zip Code:02562-2516
Mailing Address - Country:US
Mailing Address - Phone:781-534-3637
Mailing Address - Fax:
Practice Address - Street 1:81 NORRIS RD
Practice Address - Street 2:
Practice Address - City:SAGAMORE BEACH
Practice Address - State:MA
Practice Address - Zip Code:02562-2516
Practice Address - Country:US
Practice Address - Phone:781-534-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No251S00000XAgenciesCommunity/Behavioral Health