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General NPI Number Information
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NPI Number | 1295298974
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Entity Type | Individual
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Provider Name | KETCIA LIMARY SANTANA MSW
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Gender | Female
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | 128 CALLE FONT MARTELO ESQUINA RAMON GOMEZ
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-850-8382
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE 20 #579 URB VERDE MAR
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City | PUNTA SANTIAGO
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State | PR
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Zip | 00741
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Country | US
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Telephone | 787-221-1934
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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 | 14476
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License Number State | PR
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