Provider Demographics
NPI:1043532393
Name:RIVERA, MARIA C (MA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:RIVERA
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:PO BOX 2091
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-2091
Mailing Address - Country:US
Mailing Address - Phone:787-934-3682
Mailing Address - Fax:
Practice Address - Street 1:AVE NATIVO ALERS, PLAZA COPPELIA
Practice Address - Street 2:OFICINA 206
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-2091
Practice Address - Country:US
Practice Address - Phone:787-934-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1927103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling