Healthcare Provider Details

I. General information

NPI: 1700425899
Provider Name (Legal Business Name): CYNTHIA VILMARY RIJOS RIJOS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

REPTO MARIELA D12 BO QUEBRADA CRUZ
TOA ALTA PR
00953-9346
US

IV. Provider business mailing address

RR 6 BOX 7301
TOA ALTA PR
00953-9346
US

V. Phone/Fax

Practice location:
  • Phone: 939-415-7022
  • Fax:
Mailing address:
  • Phone: 939-415-7022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number6552
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15132
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: