Provider Demographics
NPI:1548580376
Name:RIVERA, MARIA ELENA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELENA
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:URB. VILLA PRADES CALLE LUIS R. MIRANDA # 811
Mailing Address - Street 2:URB. VILLA PRADES CALLE LUIS R. MIRANDA # 811
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-758-9507
Mailing Address - Fax:
Practice Address - Street 1:URB. VILLA PRADES CALLE LUIS R. MIRANDA # 811
Practice Address - Street 2:URB. VILLA PRADES CALLE LUIS R. MIRANDA # 811
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00924
Practice Address - Country:UM
Practice Address - Phone:787-758-9507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR88411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical