Provider Demographics
NPI:1811535321
Name:NIEVES, KIARA IVETTE
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:IVETTE
Last Name:NIEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIARA
Other - Middle Name:IVETTE
Other - Last Name:NIEVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2167 SWANSON DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-6601
Mailing Address - Country:US
Mailing Address - Phone:407-376-2926
Mailing Address - Fax:
Practice Address - Street 1:352 ENGLENOOK DR
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-1803
Practice Address - Country:US
Practice Address - Phone:407-732-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health