Provider Demographics
NPI:1437574936
Name:VELEZ, DIANA MIRANDA (MSW)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MIRANDA
Last Name:VELEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 CALLE NOGALES
Mailing Address - Street 2:URB. ESTANCIAS DEL BOSQUE
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739
Mailing Address - Country:US
Mailing Address - Phone:787-533-7652
Mailing Address - Fax:
Practice Address - Street 1:E 18 CALLE NOGALES
Practice Address - Street 2:URB ESTANCIAS DEL BOSQUE
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-533-7652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9914104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker