Provider Demographics
NPI:1093519167
Name:GOIRE SANTIAGO, TIFFANY DENISE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DENISE
Last Name:GOIRE SANTIAGO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:METRO PARQUE 7 STREET 1
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:877-741-4222
Mailing Address - Fax:
Practice Address - Street 1:METRO PARQUE 7 STREET 1
Practice Address - Street 2:SUITE 204
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:877-741-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1-23-63928103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst