Provider Demographics
NPI:1225203763
Name:SANTIAGO, HAYDEE (CSW)
Entity Type:Individual
Prefix:MRS
First Name:HAYDEE
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 70344
Mailing Address - Street 2:PMB 421
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-692-8804
Mailing Address - Fax:
Practice Address - Street 1:1486 F.D. ROOSEVELT AVENUE
Practice Address - Street 2:BORINQUENTOWERS 2 A-913
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-692-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR59211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical