Provider Demographics
NPI:1164910048
Name:GOICO, ENILDA YSABEL (MA)
Entity Type:Individual
Prefix:
First Name:ENILDA
Middle Name:YSABEL
Last Name:GOICO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ENILDA
Other - Middle Name:YSABEL
Other - Last Name:GOICO DE SOTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:431 GRAND ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4893
Mailing Address - Country:US
Mailing Address - Phone:912-541-1275
Mailing Address - Fax:
Practice Address - Street 1:102 PILLING ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1610
Practice Address - Country:US
Practice Address - Phone:718-602-1000
Practice Address - Fax:718-553-1111
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty