Provider Demographics
NPI:1760625388
Name:RIVERA BATALLA, MARIA DEL MAR (PSYD)
Entity Type:Individual
Prefix:
First Name:MARIA DEL MAR
Middle Name:
Last Name:RIVERA BATALLA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EST DEL MONTE
Mailing Address - Street 2:24 CALLE RIO ABAJO
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2201
Mailing Address - Country:US
Mailing Address - Phone:939-238-9856
Mailing Address - Fax:
Practice Address - Street 1:EXECUTIVE HALL CALLE FERROCARRIL 471
Practice Address - Street 2:SUITE 103 A
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:939-238-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3292103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical