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General NPI Number Information
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NPI Number | 1821858382
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Entity Type | Individual
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Provider Name | CORALY M DIAZ OLIVERO
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Gender | Female
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | BO. CEIBA SECTOR FRONTERA CARR 782 KM 3.4
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-594-6525
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 141
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City | CIDRA
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State | PR
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Zip | 00739-0141
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Country | US
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Telephone | 787-594-6525
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 10038
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 10038
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License Number State | PR
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