Provider Demographics
NPI:1992199426
Name:SANTIAGO, RUTH M (MSW)
Entity Type:Individual
Prefix:MISS
First Name:RUTH
Middle Name:M
Last Name:SANTIAGO
Suffix:
Gender:F
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:P824 CALLE 15
Mailing Address - Street 2:URB. ALTURAS DE RIO GRANDE
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-3212
Mailing Address - Country:US
Mailing Address - Phone:787-367-0654
Mailing Address - Fax:
Practice Address - Street 1:P824 CALLE 15
Practice Address - Street 2:URB. ALTURAS DE RIO GRANDE
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-3212
Practice Address - Country:US
Practice Address - Phone:787-367-0654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR176101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical