Individual
MRS. ODETTE SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
82-68 164TH STREET, JAMAICA, NY 11432
(718) 883-4944
(718) 334-5958
Mailing address
79-01 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-1921
(718) 334-5958
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12538
NY
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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