Healthcare Provider Details

I. General information

NPI: 1922925205
Provider Name (Legal Business Name): KIARA MARIE NIEVES CORTES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1259
MOCA PR
00676-1259
US

IV. Provider business mailing address

PO BOX 1259
MOCA PR
00676
US

V. Phone/Fax

Practice location:
  • Phone: 787-212-1618
  • Fax:
Mailing address:
  • Phone: 787-212-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number9107
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: