Provider Demographics
NPI:1023428166
Name:SOTO, GRISELYS (MSW)
Entity type:Individual
Prefix:MRS
First Name:GRISELYS
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:DR
Other - First Name:GRSELYS
Other - Middle Name:
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 1525
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-1525
Mailing Address - Country:US
Mailing Address - Phone:787-214-8842
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 123 KM55.8
Practice Address - Street 2:SALTO ABAJO
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:787-214-8842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5880103TC0700X
PR99491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical