Provider Demographics
NPI:1952703399
Name:SANTIAGO, DINED
Entity Type:Individual
Prefix:
First Name:DINED
Middle Name:
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:CARR. 682 KM.11.7
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614
Mailing Address - Country:UM
Mailing Address - Phone:787-406-3180
Mailing Address - Fax:
Practice Address - Street 1:66 URB CATALANA
Practice Address - Street 2:EDIFICIO COMERCIAL #1
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2725
Practice Address - Country:US
Practice Address - Phone:787-406-3180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2071235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist