Provider Demographics
NPI:1437626918
Name:FELICIANO KUILAN, AISHIA I (MSW)
Entity Type:Individual
Prefix:
First Name:AISHIA
Middle Name:I
Last Name:FELICIANO KUILAN
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:URB DORAVILLE
Mailing Address - Street 2:13A CALLE ANDALUCIA
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-943-2655
Mailing Address - Fax:
Practice Address - Street 1:URB DORAVILLE
Practice Address - Street 2:13A CALLE ANDALUCIA
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-943-2655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR144281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14428OtherPROFESSIONAL STATE LICENSE