Provider Demographics
NPI:1225675085
Name:CUEVAS COLLAZO, HEIDI J
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:J
Last Name:CUEVAS COLLAZO
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:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:GARROCHALES
Mailing Address - State:PR
Mailing Address - Zip Code:00652-0479
Mailing Address - Country:US
Mailing Address - Phone:787-207-5341
Mailing Address - Fax:
Practice Address - Street 1:EDIF PROFESIONAL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5342
Practice Address - Country:US
Practice Address - Phone:787-207-5341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-28
Last Update Date:2019-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical