Provider Demographics
NPI:1558370593
Name:RIVERA RIVERA, DELMARA (PSY D)
Entity Type:Individual
Prefix:
First Name:DELMARA
Middle Name:
Last Name:RIVERA RIVERA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CALLE GOLONDRINA
Mailing Address - Street 2:VILLAS DE CANDELERO
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-9628
Mailing Address - Country:US
Mailing Address - Phone:787-850-6106
Mailing Address - Fax:787-850-6330
Practice Address - Street 1:41 CALLE GOLONDRINA
Practice Address - Street 2:VILLAS DE CANDELERO
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-9628
Practice Address - Country:US
Practice Address - Phone:787-850-6106
Practice Address - Fax:787-850-6330
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2592103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical