Provider Demographics
NPI:1295122257
Name:DE LEON, SANTIA SANCHEZ
Entity type:Individual
Prefix:MRS
First Name:SANTIA
Middle Name:SANCHEZ
Last Name:DE LEON
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:P.O. BOX 1390
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:P.R.
Mailing Address - Zip Code:00767
Mailing Address - Country:UM
Mailing Address - Phone:787-718-3101
Mailing Address - Fax:
Practice Address - Street 1:URB. VILLA UNIVERSITARIA, CALLE 26 BA-4
Practice Address - Street 2:BO. TEJAS
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:UM
Practice Address - Phone:787-852-9331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4771103TC1900X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling