Provider Demographics
NPI:1235828336
Name:OLIVO FIGUEROA, DANELLY
Entity Type:Individual
Prefix:
First Name:DANELLY
Middle Name:
Last Name:OLIVO FIGUEROA
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:V7 CALLE SAN MARCOS
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-5044
Mailing Address - Country:US
Mailing Address - Phone:787-392-9770
Mailing Address - Fax:787-763-2480
Practice Address - Street 1:V7 CALLE SAN MARCOS
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-5044
Practice Address - Country:US
Practice Address - Phone:787-392-9770
Practice Address - Fax:787-763-2480
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR162191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical