Provider Demographics
NPI:1891412912
Name:SOTO, KARINA ELIZA (KARINA)
Entity Type:Individual
Prefix:MISS
First Name:KARINA
Middle Name:ELIZA
Last Name:SOTO
Suffix:
Gender:F
Credentials:KARINA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 WOODFORD ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-5424
Mailing Address - Country:US
Mailing Address - Phone:774-464-8097
Mailing Address - Fax:
Practice Address - Street 1:31 WOODFORD ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-5424
Practice Address - Country:US
Practice Address - Phone:774-464-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician