Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 4185 | PR |
Y | 103G00000X | Clinical Psychologist | 4185 | PR |
Y | 103TC0700X | Clinical Psychologist | 4185 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4185 | PR |
N | 103TF0000X | Family Psychologist | 4185 | PR |
NPI | 1548573298 |
---|---|
Provider Name | Dr. Yesenia Rivera |
First Address | Guaynabo, PR 00970-1676 |
Second Address | Guaynabo, PR 00969-5603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2010 |
Last Update Date | 21/05/2012 |