Provider Demographics
NPI:1093584021
Name:LUCIANO, KIARA YAMARIS (DOCTORATE)
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:YAMARIS
Last Name:LUCIANO
Suffix:
Gender:F
Credentials:DOCTORATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PUNTO ORO CALLE LAFFITE
Mailing Address - Street 2:#4325
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:787-552-0420
Mailing Address - Fax:
Practice Address - Street 1:URB PUNTO ORO CALLE LAFFITE
Practice Address - Street 2:#4325
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-552-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7817103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical