Provider Demographics
NPI:1083345029
Name:RIVERA, DENICE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DENICE
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137-3 BO CANTERA
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-4847
Mailing Address - Country:US
Mailing Address - Phone:787-549-1712
Mailing Address - Fax:
Practice Address - Street 1:137-3 BO CANTERA
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4847
Practice Address - Country:US
Practice Address - Phone:787-549-1712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR115801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical