Provider Demographics
NPI:1629781315
Name:BAEZ, KALIA SOLEIVY (MSW)
Entity Type:Individual
Prefix:
First Name:KALIA
Middle Name:SOLEIVY
Last Name:BAEZ
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:PO BOX 3083
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-3083
Mailing Address - Country:US
Mailing Address - Phone:904-866-3628
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION JARDINES DE MONTE OLIVO
Practice Address - Street 2:CALLE OSIRIS #413
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785-3083
Practice Address - Country:US
Practice Address - Phone:904-866-3628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR163081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical