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General NPI Number Information
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NPI Number | 1336430479
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Entity Type | Individual
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Provider Name | LINA I RIVERA MA
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Gender | Female
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Dates
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Enumeration Date | 04/24/2011
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Last Update Date | 04/24/2011
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Provider Practice Location Address
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Address Line | 2231 PASEO AMAPOLA LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949-4310
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Country | US
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Telephone | 787-410-1720
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Fax | 787-261-6693
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Provider Business Mailing Address
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Address Line | 2231 PASEO AMAPOLA LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949-4310
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Country | US
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Telephone | 787-410-1720
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Fax | 787-261-6693
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3466
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License Number State | PR
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