Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW11506 | FL |
NPI | 1003260886 |
---|---|
Provider Name | Mrs. Brenda Santos-Soto |
First Address | Kissimmee, FL 34746-7600 |
Second Address | Kissimmee, FL 34746-7600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 19/04/2016 |