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General NPI Number Information
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NPI Number | 1437008794
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Entity Type | Individual
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Provider Name | MARTA B DIVERSE PIERLUISSI LIC
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Gender | Female
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | CARR 114 KM 59.6 G2 BARRIO JAGUEYES
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City | VILLALBA
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State | PR
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Zip | 00766
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Country | US
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Telephone | 787-955-1140
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Fax |
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Provider Business Mailing Address
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Address Line | MANSION DEL LAGO 81 CALLE LAGO CERRILLOS
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City | COTO LAUREL
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State | PR
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Zip | 00780
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Country | US
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Telephone | 787-299-1044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1564
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License Number State | PR
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