Provider Demographics
NPI:1326814682
Name:RIVERA, LOURDES EMILY
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:EMILY
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:CALLE ALTURAS #10 BRISAS DEL ROSARIO
Mailing Address - Street 2:BZN 5562
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-602-1785
Mailing Address - Fax:
Practice Address - Street 1:CALLE ALTURAS #10 BRISAS DEL ROSARIO
Practice Address - Street 2:BZN 5562
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-602-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician