Provider Demographics
NPI:1053603159
Name:CUEVAS, NILSA TERESA
Entity type:Individual
Prefix:MRS
First Name:NILSA
Middle Name:TERESA
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 6269
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-9762
Mailing Address - Country:US
Mailing Address - Phone:787-503-9848
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 6269
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-9762
Practice Address - Country:US
Practice Address - Phone:787-503-9848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-07
Last Update Date:2011-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2245103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR462362OtherINTERNATIONAL MEDICAL CARD/FIRST MEDICAL CARD