Healthcare Provider Details

I. General information

NPI: 1851713564
Provider Name (Legal Business Name): NORMARIE RIVERA PSY D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO DE MEDICINA FAMILIAR CARR 2 KM 29. 2 BO ESPINOSA
VEGA ALTA PR
00692
US

IV. Provider business mailing address

CENTRO DE MEDICINA FAMILIAR CARR 2 KM 29. 2 BO ESPINOSA
VEGA ALTA PR
00692
US

V. Phone/Fax

Practice location:
  • Phone: 787-626-9117
  • Fax: 787-626-3619
Mailing address:
  • Phone: 787-626-9117
  • Fax: 787-626-3619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5550
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: