Provider Demographics
NPI:1790050342
Name:RIVERA COTTO, MARIBEL (PSYD)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:RIVERA COTTO
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:B34 JARD DE BUENA VIS
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-3222
Mailing Address - Country:US
Mailing Address - Phone:787-633-2388
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 734 KM 05
Practice Address - Street 2:BO. ARENAS
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-633-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2083103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist