Provider Demographics
NPI:1497024814
Name:RIVERA, HILDA LUZ
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:LUZ
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 1:61 CALLE SAN JOSE E
Mailing Address - Street 2:PO BOX 2024
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3541
Mailing Address - Country:US
Mailing Address - Phone:787-735-6467
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 6599
Practice Address - Street 2:AIBONITO
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-9764
Practice Address - Country:US
Practice Address - Phone:787-735-6467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0937101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional