Provider Demographics
NPI:1154617363
Name:SANTORO, SIGNE MARIA (OT)
Entity type:Individual
Prefix:
First Name:SIGNE
Middle Name:MARIA
Last Name:SANTORO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 W NORTH LOOP BLVD APT 122
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2314
Mailing Address - Country:US
Mailing Address - Phone:512-296-6685
Mailing Address - Fax:
Practice Address - Street 1:2211 W NORTH LOOP BLVD APT 122
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2314
Practice Address - Country:US
Practice Address - Phone:512-296-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-26
Last Update Date:2011-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100387225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist