Provider Demographics
NPI:1831377324
Name:SANTIAGO, JOANNIE (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:JOANNIE
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 4 BOX 895
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-9681
Mailing Address - Country:US
Mailing Address - Phone:787-248-3756
Mailing Address - Fax:
Practice Address - Street 1:RR 4 BOX 895
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-9681
Practice Address - Country:US
Practice Address - Phone:787-248-3756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9055104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker