Provider Demographics
NPI:1386045086
Name:SANTIAGO, KRISTIN (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3220
Mailing Address - Country:US
Mailing Address - Phone:512-454-3743
Mailing Address - Fax:
Practice Address - Street 1:1121 E 7TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3220
Practice Address - Country:US
Practice Address - Phone:512-454-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator