Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1932 | PR |
N | 103G00000X | Clinical Psychologist | 1932 | PR |
N | 103TC0700X | Clinical Psychologist | 1932 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1932 | PR |
NPI | 1295862530 |
---|---|
Provider Name | Dr. Billy Benjamin Santiago |
First Address | San Juan, PR 00923-3228 |
Second Address | San Juan, PR 00918-3416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |