| NPI | 1144709379 |
|---|---|
| Former Name | ROBERT SANTIAGO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CTB20230533) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM CMH0222381) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2023-10-10 |