Provider Demographics
NPI:1982835955
Name:SOTO, MARIA TERESA
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:TERESA
Last Name:SOTO
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:AVE. VILLA DEL CARMEN SAMARIA
Mailing Address - Street 2:ST. 950
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:939-717-5001
Mailing Address - Fax:
Practice Address - Street 1:950 CALLE SAMARIA
Practice Address - Street 2:VILLA DEL CARMEN
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2127
Practice Address - Country:US
Practice Address - Phone:939-717-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist