Healthcare Provider Details

I. General information

NPI: 1720917826
Provider Name (Legal Business Name): KRISHNARA MARIE RIVERA GARAY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 2 BOX 6760
MANATI PR
00674-9642
US

IV. Provider business mailing address

RR 2 BOX 6760
MANATI PR
00674-9642
US

V. Phone/Fax

Practice location:
  • Phone: 787-549-0637
  • Fax:
Mailing address:
  • Phone: 787-549-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17465
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: