Provider Demographics
NPI:1851713564
Name:RIVERA, NORMARIE (PSY D)
Entity Type:Individual
Prefix:DR
First Name:NORMARIE
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTRO DE MEDICINA FAMILIAR CARR 2
Mailing Address - Street 2:KM 29. 2 BO ESPINOSA
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:US
Mailing Address - Phone:787-626-9117
Mailing Address - Fax:787-626-3619
Practice Address - Street 1:CENTRO DE MEDICINA FAMILIAR CARR 2
Practice Address - Street 2:KM 29. 2 BO ESPINOSA
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-626-9117
Practice Address - Fax:787-626-3619
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5550103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical