Doctor Name: | ANTONIO RIVERA SANTIAGO |
NPI Number: | 1003969544 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2138 |
Business Practice Address: | 1 Calle Nazario Caguas, PR - 007252683 |
Business Phone Number: | 7876536775 |
Business Fax Number: | 7876536779 |
Mailing Address: | 23102 Urb Serenna, CAGUAS |
State: | PR |
Postal Code: | 007273347 |
Phone Number: | 7876405488 |
Fax Number: | 7876536779 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 2138 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |