Individual
DR. EDUARDO SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
400 S BROADWAY # 6, EDMOND, OK 73034-3848
(580) 512-0193
Mailing address
104 MAPLE ST, ELGIN, OK 73538-8835
(580) 512-0193
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
OK
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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