Provider Demographics
NPI:1780427823
Name:SANCHEZ SANTIAGO, URDA MARIELA (PHD)
Entity type:Individual
Prefix:DR
First Name:URDA
Middle Name:MARIELA
Last Name:SANCHEZ SANTIAGO
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 CALLE PALMA
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-3202
Mailing Address - Country:US
Mailing Address - Phone:939-335-3611
Mailing Address - Fax:
Practice Address - Street 1:CARR. 1 KM 113.9
Practice Address - Street 2:BO. PASTILLO
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-580-7633
Practice Address - Fax:787-580-7633
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8038103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical