Healthcare Provider Details

I. General information

NPI: 1982337796
Provider Name (Legal Business Name): MARIELLI RIVERA RIVERA PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CALLE ACUARELA SUITE A-06
GUAYNABO PR
00969-3577
US

IV. Provider business mailing address

URB TOA ALTA HEIGHTS CALLE 27 AA48
TOA ALTA PR
00953-2010
US

V. Phone/Fax

Practice location:
  • Phone: 939-881-1809
  • Fax:
Mailing address:
  • Phone: 939-881-1809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6421
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: