Provider Demographics
NPI:1205143955
Name:BARRIGA SAN MIGUEL, ALDA
Entity type:Individual
Prefix:
First Name:ALDA
Middle Name:
Last Name:BARRIGA SAN MIGUEL
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 1:1139 PROSPECT AVE APT 1H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1139
Mailing Address - Country:US
Mailing Address - Phone:646-464-5222
Mailing Address - Fax:
Practice Address - Street 1:1139 PROSPECT AVE APT 1H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1139
Practice Address - Country:US
Practice Address - Phone:646-464-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool