Provider Demographics
NPI:1689983496
Name:SOTO-HERNANDEZ, ELVIN (MSW)
Entity Type:Individual
Prefix:MR
First Name:ELVIN
Middle Name:
Last Name:SOTO-HERNANDEZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12012 CALLE GUAJANA
Mailing Address - Street 2:URB. ESTANCIAS DEL MAYORAL
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-2430
Mailing Address - Country:US
Mailing Address - Phone:939-630-0860
Mailing Address - Fax:
Practice Address - Street 1:12012 CALLE GUAJANA
Practice Address - Street 2:URB. ESTANCIAS DEL MAYORAL
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-2430
Practice Address - Country:US
Practice Address - Phone:939-630-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR104531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical