Provider Demographics
NPI:1144400995
Name:RIVERA, SYLVIA M (MA)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:M
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MA
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 326
Mailing Address - Street 2:
Mailing Address - City:VIEGUES
Mailing Address - State:PR
Mailing Address - Zip Code:00765
Mailing Address - Country:US
Mailing Address - Phone:787-741-4767
Mailing Address - Fax:787-741-2550
Practice Address - Street 1:BO DESTINO CARR 200 KM 1
Practice Address - Street 2:
Practice Address - City:VIEGUES
Practice Address - State:PR
Practice Address - Zip Code:00765
Practice Address - Country:US
Practice Address - Phone:787-741-4767
Practice Address - Fax:787-741-2550
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1335103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical