Provider Demographics
NPI:1235769811
Name:RIVERA, YAMILA MAXIMINA
Entity Type:Individual
Prefix:MRS
First Name:YAMILA
Middle Name:MAXIMINA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 DEMOCRACY BLVD # FC7
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1018
Mailing Address - Country:US
Mailing Address - Phone:301-365-0209
Mailing Address - Fax:
Practice Address - Street 1:7101 DEMOCRACY BLVD # FC7
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1018
Practice Address - Country:US
Practice Address - Phone:301-365-0209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging