Individual
ISMAEL SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1116 SW 59TH ST APT 1, OKLAHOMA CITY, OK 73109-4908
(405) 887-9639
Mailing address
1116 SW 59TH ST APT 1, OKLAHOMA CITY, OK 73109-4908
(405) 887-9639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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