Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1927 | PR |
NPI | 1043532393 |
---|---|
Provider Name | Maria C Rivera |
First Address | Aguada, PR 00602-2091 |
Second Address | Aguada, PR 00602-2091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2010 |
Last Update Date | 26/02/2010 |