Provider Demographics
NPI:1003573106
Name:LIMERY-NIEVES, GIASSELLE A
Entity Type:Individual
Prefix:MS
First Name:GIASSELLE
Middle Name:A
Last Name:LIMERY-NIEVES
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 1:500 CALLE MORELL CAMPOS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00915-4312
Mailing Address - Country:US
Mailing Address - Phone:939-350-3221
Mailing Address - Fax:
Practice Address - Street 1:CARR. 833 KM. 12.2 CALLE FICUS A1 SANTA ROSA III
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-435-2321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7012103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist