Provider Demographics
NPI:1205623428
Name:TORRES RIVERA, CAMILLE DESIREE (OT)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:DESIREE
Last Name:TORRES RIVERA
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CONSTANCIA APT GRANADA A5
Mailing Address - Street 2:CALLE EUREKA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:939-732-5127
Mailing Address - Fax:
Practice Address - Street 1:GALERIA PROFESIONAL 8118
Practice Address - Street 2:CALLE CONCORDIA SUITE 102
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1589
Practice Address - Country:US
Practice Address - Phone:939-732-5127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1354225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist