Healthcare Provider Details

I. General information

NPI: 1689716961
Provider Name (Legal Business Name): HILDA DORIS NIEVES PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 2 KM 45 SECTOR CANTERA
MANATI PR
00674-0000
US

IV. Provider business mailing address

PO BOX 918
MANATI PR
00674-0918
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-2528
  • Fax:
Mailing address:
  • Phone: 787-884-2528
  • Fax: 787-884-2528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1571
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: