Provider Demographics
NPI:1386190528
Name:RIVERA-GIRAUD, MARIA DEL PILAR (LIC)
Entity Type:Individual
Prefix:
First Name:MARIA DEL
Middle Name:PILAR
Last Name:RIVERA-GIRAUD
Suffix:
Gender:F
Credentials:LIC
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 309
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0309
Mailing Address - Country:US
Mailing Address - Phone:787-344-6737
Mailing Address - Fax:
Practice Address - Street 1:1607 AVE. PONCE DE LEON
Practice Address - Street 2:EDIFICIO COBIANS PLAZA SUITE 305
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00940
Practice Address - Country:US
Practice Address - Phone:787-344-6737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1188101YP2500X
PR5717103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional