Individual
MARISOL DE LOS SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
172 E 205TH ST APT 2F10458, BRONX, NY 10458-1233
(917) 484-3711
Mailing address
172 E 205TH ST APT 2F10458, BRONX, NY 10458-1233
(917) 484-3711
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1112453
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
644174121
TEACHER CERTIFICATION GENERAL ED- BIRTH -SECOND GRADE
NY
01
—
705065131
TEACHER CERTIFICATION SPECIAL EDUCATION BIRTH-SENCOND GRADE
NY
Enumeration date
02/05/2013
Last updated
02/05/2013
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