Provider Demographics
NPI:1942753991
Name:RIBEIRO DA SILVA DOS SANTOS, LETICIA (PHD STUDENT)
Entity Type:Individual
Prefix:MISS
First Name:LETICIA
Middle Name:
Last Name:RIBEIRO DA SILVA DOS SANTOS
Suffix:
Gender:F
Credentials:PHD STUDENT
Other - Prefix:MISS
Other - First Name:LETICIA
Other - Middle Name:
Other - Last Name:RIBEIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD STUDENT
Mailing Address - Street 1:18673 NW CEDAR FALLS LOOP
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6083
Mailing Address - Country:US
Mailing Address - Phone:503-804-4450
Mailing Address - Fax:
Practice Address - Street 1:222 SE 8TH AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4218
Practice Address - Country:US
Practice Address - Phone:503-352-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health