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General NPI Number Information
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NPI Number | 1104122092
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Entity Type | Individual
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Provider Name | WILMARIE RIVERA PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/10/2011
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 3 CARR 172, KM 19.6 BO CANABONCITO
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City | CAGUAS
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State | PR
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Zip | 00727
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Country | US
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Telephone | 787-661-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 376 CAMINO DE LOS FLAMBOYANES
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City | CIDRA
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State | PR
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Zip | 00739-9444
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Country | US
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Telephone | 787-661-0800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3937
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License Number State | PR
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