Provider Demographics
NPI:1639188592
Name:TORRES-RIVERA, WANDA I (OT)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:I
Last Name:TORRES-RIVERA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. RIO CANAS
Mailing Address - Street 2:C/ COLORADO #2116
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1823
Mailing Address - Country:US
Mailing Address - Phone:787-844-7796
Mailing Address - Fax:
Practice Address - Street 1:URB RIO CANAS
Practice Address - Street 2:C/ COLORADO #2116
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1823
Practice Address - Country:US
Practice Address - Phone:787-844-7796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR609225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist