Provider Demographics
NPI:1861827784
Name:RIVERA, VIVIANA
Entity Type:Individual
Prefix:MISS
First Name:VIVIANA
Middle Name:
Last Name:RIVERA
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 1:85 CALLE TOPACIO
Mailing Address - Street 2:URB. FREIRE
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-3135
Mailing Address - Country:US
Mailing Address - Phone:787-310-4754
Mailing Address - Fax:
Practice Address - Street 1:85 CALLE TOPACIO
Practice Address - Street 2:URB. FREIRE
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3135
Practice Address - Country:US
Practice Address - Phone:787-310-4754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist