Provider Demographics
NPI:1720690969
Name:SOTO MARTINEZ, PAULETTE TERESA (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:TERESA
Last Name:SOTO MARTINEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 CALLE TURIN
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2221
Mailing Address - Country:US
Mailing Address - Phone:787-974-3773
Mailing Address - Fax:
Practice Address - Street 1:22 CALLE SOL
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3820
Practice Address - Country:US
Practice Address - Phone:787-974-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6581103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical