Provider Demographics
NPI:1760975171
Name:RIVERA, EILEEN ZORAYA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:ZORAYA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 57516
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9750
Mailing Address - Country:US
Mailing Address - Phone:939-257-9633
Mailing Address - Fax:
Practice Address - Street 1:CARRETRA 487 KM 5
Practice Address - Street 2:BARRIO BAYANEY SECTOR SONADORA
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:939-257-9633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR92701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9270OtherDEPARTEMENTO DE ESTADO DE PUERTO RICO