Provider Demographics
NPI:1194069567
Name:RIOS RIVERA, NISHBETH GIMAR (PSYD)
Entity type:Individual
Prefix:DR
First Name:NISHBETH
Middle Name:GIMAR
Last Name:RIOS RIVERA
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 1:238 LA REPRESA
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-6913
Mailing Address - Country:US
Mailing Address - Phone:787-925-5511
Mailing Address - Fax:
Practice Address - Street 1:238 LA REPRESA
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-6913
Practice Address - Country:US
Practice Address - Phone:787-566-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-24
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4328103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical