Provider Demographics
NPI:1265869283
Name:MARRERO SIERRA, SOLMARY (PSYD, LND)
Entity type:Individual
Prefix:
First Name:SOLMARY
Middle Name:
Last Name:MARRERO SIERRA
Suffix:
Gender:F
Credentials:PSYD, LND
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 50982
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-0982
Mailing Address - Country:US
Mailing Address - Phone:939-218-1844
Mailing Address - Fax:787-785-6680
Practice Address - Street 1:J16 CALLE 2
Practice Address - Street 2:101-A EDIF. HERMANAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5041
Practice Address - Country:US
Practice Address - Phone:939-218-1844
Practice Address - Fax:787-785-6680
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1360133N00000X
PR4013103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No133N00000XDietary & Nutritional Service ProvidersNutritionist