Provider Demographics
NPI:1093201501
Name:RIVERA OCASIO, VILMARIE (MS, PHL)
Entity Type:Individual
Prefix:MISS
First Name:VILMARIE
Middle Name:
Last Name:RIVERA OCASIO
Suffix:
Gender:F
Credentials:MS, PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 715
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-0715
Mailing Address - Country:US
Mailing Address - Phone:787-481-0114
Mailing Address - Fax:
Practice Address - Street 1:66 URBANIZACION CATALANA
Practice Address - Street 2:EDIFICIO COMERCIAL LOCAL 1 CALLE GEORGETTI
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-915-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist