Provider Demographics
NPI:1174169296
Name:COTTO TORRES, ISIS CORALYS
Entity type:Individual
Prefix:
First Name:ISIS
Middle Name:CORALYS
Last Name:COTTO TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ISIS
Other - Middle Name:C
Other - Last Name:COTTO TORRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:URB. LOS PRADOS
Mailing Address - Street 2:SECT. EL VALLE BZ.323
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-310-1250
Mailing Address - Fax:
Practice Address - Street 1:URB. LOS PRADOS SECT. EL VALLE BZ. 323
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-0072
Practice Address - Country:US
Practice Address - Phone:787-310-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14338104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker