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NPI Code Detail

MEDICARE: DENISE PUERTO

MEDICARE: DENISE PUERTO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist03007KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053920355
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE PUERTO
Provider Business Mailing Address
First Line : 400 S SANTA FE AVE
Second Line :
City : SALINA
State : KS
Zip : 67401-4144
Country : US
Telephone Number : 785-452-4948
Fax Number :
Provider Business Practice Location Address
First Line : 730 HOLLY LN
Second Line :
City : SALINA
State : KS
Zip : 67401-8452
Country : US
Telephone Number : 785-452-4948
Fax Number : 785-452-6119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2020
Last Update Date : 10/27/2023

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Directions to “ DENISE PUERTO ” Practice Location

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