Provider Demographics
NPI:1710235726
Name:RIVERA, DORCAS (PSYDD)
Entity Type:Individual
Prefix:DR
First Name:DORCAS
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PSYDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE PARQUE BORINQUEN 5J22
Mailing Address - Street 2:VILLA FONTANA, PARK
Mailing Address - City:CAROLINA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00983
Mailing Address - Country:UM
Mailing Address - Phone:787-697-3123
Mailing Address - Fax:
Practice Address - Street 1:5J22 CALLE PARQUE BORINQUEN
Practice Address - Street 2:VILLA FONTANA, PARK
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-3718
Practice Address - Country:US
Practice Address - Phone:787-697-3123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4180103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical