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NPI 1760890164

NPI 1760890164 : MELISSA RIVERA PHD : AGANA HEIGHTS, GU

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General NPI Number Information
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    NPI Number           |    1760890164
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA RIVERA PHD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/29/2014
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    Last Update Date     |    09/10/2025
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Provider Practice Location Address
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    Address Line         |    BLDG 50, FARENHOLT AVENUE 
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    City                 |    AGANA HEIGHTS
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    State                |    GU
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    Zip                  |    96910
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    Country              |    US
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    Telephone            |    671-344-9340
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PSC 455 BOX 208 
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    City                 |    FPO
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    State                |    AP
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    Zip                  |    96540-0003
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    Country              |    US
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    Telephone            |    671-344-9340
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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       |    05551
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    License Number State |    PR
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