Provider Demographics
NPI:1710759782
Name:RIVAS DEL TORO, MARIA CELINA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CELINA
Last Name:RIVAS DEL TORO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LEDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-1250
Mailing Address - Country:US
Mailing Address - Phone:508-873-2790
Mailing Address - Fax:
Practice Address - Street 1:625 MAIN ST APT 208
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-3496
Practice Address - Country:US
Practice Address - Phone:877-733-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist