Provider Demographics
NPI:1619689155
Name:RIVERA CORTES, DANA (THL)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:RIVERA CORTES
Suffix:
Gender:F
Credentials:THL
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:RIVERA CORTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:THL
Mailing Address - Street 1:115 AVE BARBOSA
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962-4780
Mailing Address - Country:US
Mailing Address - Phone:787-317-6682
Mailing Address - Fax:
Practice Address - Street 1:115 AVE BARBOSA
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-4780
Practice Address - Country:US
Practice Address - Phone:787-317-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13182355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant