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General NPI Number Information
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NPI Number | 1265160527
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Entity Type | Individual
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Provider Name | KAREN S GOMEZ SOTO I
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Gender | Female
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | CARR 3 KM 152.1 BARRIADA LOPEZ
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City | AGUIRRE
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State | PR
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Zip | 00704
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Country | US
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Telephone | 787-535-8131
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Fax |
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Provider Business Mailing Address
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Address Line | URB. BRISAS DEL MAR CALLE SIRENA #O-37
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City | GUAYAMA
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State | PR
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Zip | 00784
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Country | US
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Telephone | 787-535-8131
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10482
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License Number State | PR
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