Provider Demographics
NPI:1932977337
Name:SUAREZ SANTIAGO, ZULMARIS SOFIA (MA)
Entity Type:Individual
Prefix:
First Name:ZULMARIS
Middle Name:SOFIA
Last Name:SUAREZ SANTIAGO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CARR 842 APT 138
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9672
Mailing Address - Country:US
Mailing Address - Phone:787-374-6919
Mailing Address - Fax:
Practice Address - Street 1:COND PARQUE TERRALINDA
Practice Address - Street 2:EDF U APTO 2
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-374-6919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7473103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty