Individual
MIRAYDA NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 KS-5 AVE. FRAGOSO, VIA MIRTA., VILLA FONTANA, CAROLINA, PR 00983
(787) 628-6668
Mailing address
783 CALLE JOSE B. ACEVEDO, SAN JUAN, PR 00923
(787) 628-6668
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
004670
PR
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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