Provider Demographics
NPI:1407736770
Name:HERNANDEZ SOTO, WILGLORY T (CPLP)
Entity type:Individual
Prefix:
First Name:WILGLORY
Middle Name:T
Last Name:HERNANDEZ SOTO
Suffix:
Gender:F
Credentials:CPLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2020
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-2001
Mailing Address - Country:US
Mailing Address - Phone:939-209-8693
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2020
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-2001
Practice Address - Country:US
Practice Address - Phone:939-209-8693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPR57430101YA0400X
PR1790101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)