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General NPI Number Information
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NPI Number | 1982037198
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Entity Type | Individual
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Provider Name | EUNICE RIVERA-MIRANDA PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 110 MAPLE ST
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City | SPRINGFIELD
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State | MA
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Zip | 01105-1864
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Country | US
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Telephone | 413-304-2948
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Fax |
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Provider Business Mailing Address
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Address Line | 372 PARK ST APT 2
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-3355
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Country | US
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Telephone | 787-394-4444
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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 | 003799
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License Number State | CT
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