Provider Demographics
NPI:1700353844
Name:SANTIAGO, EMILY POPP (MS, EDS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:POPP
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:MS, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18360 CALDART AVE NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8775
Mailing Address - Country:US
Mailing Address - Phone:360-396-3959
Mailing Address - Fax:
Practice Address - Street 1:18360 CALDART AVE NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8775
Practice Address - Country:US
Practice Address - Phone:360-396-3959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool