Provider Demographics
NPI:1497014401
Name:SOTO, MIGDALIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:MIGDALIA
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 LAFAYETTE AVE
Mailing Address - Street 2:10A
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4719
Mailing Address - Country:US
Mailing Address - Phone:917-912-6495
Mailing Address - Fax:973-815-0692
Practice Address - Street 1:180 LAFAYETTE AVE
Practice Address - Street 2:10A
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4719
Practice Address - Country:US
Practice Address - Phone:917-912-6495
Practice Address - Fax:973-815-0692
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070562-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker