Provider Demographics
NPI:1245421858
Name:RIVERA, MILAGROS S (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:S
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:PO BOX 6604
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6604
Mailing Address - Country:US
Mailing Address - Phone:787-543-9022
Mailing Address - Fax:
Practice Address - Street 1:7 CALLE GUARIONEX
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4431
Practice Address - Country:US
Practice Address - Phone:787-767-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical