Provider Demographics
NPI:1396560926
Name:TORRES SANTIAGO, JESENIA (MA)
Entity type:Individual
Prefix:
First Name:JESENIA
Middle Name:
Last Name:TORRES SANTIAGO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 CALLE HELIO
Mailing Address - Street 2:URB. LOS AIRES
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-0000
Mailing Address - Country:US
Mailing Address - Phone:787-457-7351
Mailing Address - Fax:
Practice Address - Street 1:CARR 10 R 651 KM 2.4
Practice Address - Street 2:SEC. EL JUNCO, BO. JUNCOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-956-0062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7284103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling