Provider Demographics
NPI:1932880341
Name:CERDA, DORIAM ADELFY (LICENCIADA)
Entity Type:Individual
Prefix:MISS
First Name:DORIAM
Middle Name:ADELFY
Last Name:CERDA
Suffix:
Gender:F
Credentials:LICENCIADA
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 11715
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1715
Mailing Address - Country:US
Mailing Address - Phone:787-549-6871
Mailing Address - Fax:
Practice Address - Street 1:115 AVE BARBOSA
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-4780
Practice Address - Country:US
Practice Address - Phone:939-336-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR77412355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty