| Doctor Name: | EDWARD SANTIAGO |
| NPI Number: | 1013226083 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | 1589 |
| Business Practice Address: | 410 Ave Hostos Suite 6 Mayaguez, PR - 006821560 |
| Business Phone Number: | 7878342115 |
| Business Fax Number: | |
| Mailing Address: | Pmb 79 P.o. Box 5103, CABO ROJO |
| State: | PR |
| Postal Code: | 00623 |
| Phone Number: | 7878342115 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2010 |
| NPI Last Update Date: | 09/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 1589 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |