Provider Demographics
NPI:1366646903
Name:SOTO, HAYDEE HERNANDEZ (MA EDUCATIONAL PSYCH)
Entity type:Individual
Prefix:
First Name:HAYDEE
Middle Name:HERNANDEZ
Last Name:SOTO
Suffix:
Gender:F
Credentials:MA EDUCATIONAL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 1405
Mailing Address - Street 2:CALLE YODRE SELVA #1 URBANIZACION NELMARIE
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-431-5561
Mailing Address - Fax:787-872-5536
Practice Address - Street 1:CALLE LAMELA #118
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-633-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR679103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist