Provider Demographics
NPI:1053563817
Name:PEREZ RIVERA, AMALYN (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMALYN
Middle Name:
Last Name:PEREZ 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 1:3181 CALLE RIO BUCANA
Mailing Address - Street 2:PRADERA DEL RIO
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9118
Mailing Address - Country:US
Mailing Address - Phone:939-644-1500
Mailing Address - Fax:
Practice Address - Street 1:3181 CALLE RIO BUCANA
Practice Address - Street 2:PRADERA DEL RIO
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-9118
Practice Address - Country:US
Practice Address - Phone:939-644-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2583103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical