Provider Demographics
NPI:1760369003
Name:COTTO, MIRIAM
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:COTTO
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 1:19 CALLE ACUARIO # URB
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4933
Mailing Address - Country:US
Mailing Address - Phone:787-406-4445
Mailing Address - Fax:787-406-4445
Practice Address - Street 1:URB VENUS GARDENS
Practice Address - Street 2:805 CALLE ENEAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4933
Practice Address - Country:US
Practice Address - Phone:787-406-4445
Practice Address - Fax:787-406-4445
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3522103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool