Provider Demographics
NPI:1871922930
Name:SOTO PEREZ, SARAH (MSW LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SOTO PEREZ
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 9551
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9043
Mailing Address - Country:US
Mailing Address - Phone:787-908-0496
Mailing Address - Fax:787-891-7175
Practice Address - Street 1:CARR 110 KM 21
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-908-0496
Practice Address - Fax:787-891-7175
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR129081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical