Provider Demographics
NPI:1942741194
Name:OTERO NIEVES, LORNNA (COUNSELOR)
Entity Type:Individual
Prefix:MISS
First Name:LORNNA
Middle Name:
Last Name:OTERO NIEVES
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CI13 CALLE DR ZENO GANDIA
Mailing Address - Street 2:LEVITTOWN LAKES
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3345
Mailing Address - Country:US
Mailing Address - Phone:787-459-4153
Mailing Address - Fax:
Practice Address - Street 1:CI13 CALLE DR ZENO GANDIA
Practice Address - Street 2:LEVITTOWN LAKES
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-459-4153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4280101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)