MEDICARE: MRS. MARILYN SOTO ESCRIBANO PSYCOLOGIST

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
1	103TC1900X	Counseling Psychologist	6709	PR

General Provider Information

NPI Number	:	1689336653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARILYN SOTO ESCRIBANO PSYCOLOGIST

Provider Business Mailing Address
First Line	:	HC 15 BOX 16020
Second Line	:
City	:	HUMACAO
State	:	PR
Zip	:	00791-9746
Country	:	US
Telephone Number	:	787-908-4180
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR. 198 KM. 24.0
Second Line	:
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00791
Country	:	US
Telephone Number	:	787-908-4180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2021
Last Update Date	:	10/07/2021

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