Provider Demographics
NPI:1043742380
Name:TORRES-RIVERA, IRMA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:
Last Name:TORRES-RIVERA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 CALLE CESAR GONZALEZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2637
Mailing Address - Country:US
Mailing Address - Phone:787-479-5666
Mailing Address - Fax:
Practice Address - Street 1:475 CALLE CESAR GONZALEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2637
Practice Address - Country:US
Practice Address - Phone:787-479-5666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5885103TH0100X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service