Provider Demographics
NPI:1508347436
Name:CRUZ RIVERA, YANIRA (LPC, EDD)
Entity Type:Individual
Prefix:DR
First Name:YANIRA
Middle Name:
Last Name:CRUZ RIVERA
Suffix:
Gender:F
Credentials:LPC, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CARR 831 LA FLORESTA APT 1421
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-459-4212
Mailing Address - Fax:
Practice Address - Street 1:1000 CARR 831 LA FLORESTA APT 1421
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-459-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional