Provider Demographics
NPI:1356905897
Name:CALDERON-OLIVERO, MARILYN (MSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:CALDERON-OLIVERO
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:HC 1 BOX 6312
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-9884
Mailing Address - Country:US
Mailing Address - Phone:787-376-7724
Mailing Address - Fax:
Practice Address - Street 1:BO SAN ANTON COMUNIDAD ESCORIAL
Practice Address - Street 2:1500 AVENIDA SUR
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00986
Practice Address - Country:US
Practice Address - Phone:787-757-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8173104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker