Provider Demographics
NPI:1407034176
Name:SANTIAGO, LINETTE
Entity Type:Individual
Prefix:
First Name:LINETTE
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CALLE ANASCO
Mailing Address - Street 2:URB. BONNEVILLE HEIGTHS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-4955
Mailing Address - Country:US
Mailing Address - Phone:787-429-6034
Mailing Address - Fax:787-727-2760
Practice Address - Street 1:9 CALLE ANASCO
Practice Address - Street 2:URB. BONNEVILLE HEIGTHS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-4955
Practice Address - Country:US
Practice Address - Phone:787-429-6034
Practice Address - Fax:787-727-2760
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR159491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical