Provider Demographics
NPI:1780124032
Name:SOTO SEDA, ANAMARIE (PSYD)
Entity type:Individual
Prefix:
First Name:ANAMARIE
Middle Name:
Last Name:SOTO SEDA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CALLE BAYAHONDA
Mailing Address - Street 2:URB REMANSO DE CABO ROJO
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3815
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1011 CALLE BAYAHONDA
Practice Address - Street 2:URB REMANSO DE CABO ROJO
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-3815
Practice Address - Country:US
Practice Address - Phone:787-640-3041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5881103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical