Provider Demographics
NPI:1336446301
Name:ALICEA NIEVES, ALBAROSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALBAROSA
Middle Name:
Last Name:ALICEA NIEVES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CALLE BELT
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-1105
Mailing Address - Country:US
Mailing Address - Phone:787-672-1540
Mailing Address - Fax:787-986-7494
Practice Address - Street 1:115 CALLE BELT
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-1105
Practice Address - Country:US
Practice Address - Phone:787-672-1540
Practice Address - Fax:787-986-7494
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2014-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3844103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical