Provider Demographics
NPI:1053078535
Name:RIVERA ECHEANDIA, MARIA DEL MAR (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA DEL MAR
Middle Name:
Last Name:RIVERA ECHEANDIA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 CALLE ATUN
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1444
Mailing Address - Country:US
Mailing Address - Phone:787-380-5781
Mailing Address - Fax:
Practice Address - Street 1:SANTA MARIA SHOPPING CENTER LOCAL A-13
Practice Address - Street 2:AVE LOMAS VERDES
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-380-5781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist