Provider Demographics
NPI:1093849028
Name:COLTON RIVERA, MARIA MAGDALENA (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MAGDALENA
Last Name:COLTON 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:K17 COLINA COLLORES
Mailing Address - Street 2:URB. LAS COLINAS
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4919
Mailing Address - Country:US
Mailing Address - Phone:787-210-0003
Mailing Address - Fax:787-251-2400
Practice Address - Street 1:URB DORADO DEL MAR
Practice Address - Street 2:A18 NINFA DEL MAR
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-2121
Practice Address - Country:US
Practice Address - Phone:787-210-0003
Practice Address - Fax:787-251-2400
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002240103TC0700X
PR2240103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical