Provider Demographics
NPI:1831545169
Name:SANTIAGO, YAHAIRA B
Entity type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:B
Last Name:SANTIAGO
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 1:2528 VALE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2866
Mailing Address - Country:US
Mailing Address - Phone:813-451-6744
Mailing Address - Fax:
Practice Address - Street 1:587 E SR 434
Practice Address - Street 2:SUITE 1021
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5201
Practice Address - Country:US
Practice Address - Phone:407-331-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist