Individual
MRS. IDALIS RIVERA BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASTER DEGREE
Contact information
Practice address
HC 2 BOX 4750, COAMO, PR 00769-9575
(787) 392-7673
Mailing address
HC 2 BOX 4750, COAMO, PR 00769-9575
(787) 392-7673
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2790
PR
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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