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General NPI Number Information
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NPI Number | 1255587861
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Entity Type | Individual
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Provider Name | WALESKA SANTIAGO PAGAN PSY.D
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Gender | Female
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | M 239 CARR. 2 VILLA CAPARRA
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City | GUAYNABO
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State | PR
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Zip | 00966-1915
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Country | US
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Telephone | 787-354-3735
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Fax | 787-354-3735
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Provider Business Mailing Address
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Address Line | M6 CALLE 14 URB ESTANCIAS LAS TRINITARIAS
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City | SALINAS
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State | PR
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Zip | 00704
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Country | US
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Telephone | 787-354-3735
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Fax | 787-354-3735
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3165
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License Number State | PR
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