Doctor Name: | DORA M. SANTOS |
NPI Number: | 1184633299 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSED |
License Number: | MH 4696 |
Business Practice Address: | 4469 Nw 167th St Opa Locka, FL - 330554311 |
Business Phone Number: | 3056211455 |
Business Fax Number: | 3056215508 |
Mailing Address: | 11031 Ne 6th Ave, MIAMI |
State: | FL |
Postal Code: | 331617182 |
Phone Number: | 3053986100 |
Fax Number: | 3057574465 |
NPI Enumeration Date: | 08/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH 4696 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |