Provider Demographics
NPI:1801631734
Name:CADIZ NIEVES, GLORIAN (MA)
Entity type:Individual
Prefix:MISS
First Name:GLORIAN
Middle Name:
Last Name:CADIZ NIEVES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 10370
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-7950
Mailing Address - Country:US
Mailing Address - Phone:787-516-5636
Mailing Address - Fax:
Practice Address - Street 1:2301 CARR 2
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-3240
Practice Address - Country:US
Practice Address - Phone:787-372-3736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4865-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty