Provider Demographics
NPI:1023737913
Name:SANTIAGO, GIANIRDA
Entity type:Individual
Prefix:
First Name:GIANIRDA
Middle Name:
Last Name:SANTIAGO
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 1:218 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-2902
Mailing Address - Country:US
Mailing Address - Phone:610-507-1699
Mailing Address - Fax:
Practice Address - Street 1:4641 POTTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9707
Practice Address - Country:US
Practice Address - Phone:484-578-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional