Provider Demographics
NPI:1851882880
Name:SAAVEREDRA, KIARA DENISSE (ATO)
Entity Type:Individual
Prefix:MISS
First Name:KIARA
Middle Name:DENISSE
Last Name:SAAVEREDRA
Suffix:
Gender:F
Credentials:ATO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8826 CARR 484
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-9740
Mailing Address - Country:US
Mailing Address - Phone:787-895-4615
Mailing Address - Fax:
Practice Address - Street 1:8826 CARR 484
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-9740
Practice Address - Country:US
Practice Address - Phone:787-895-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2097-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant