Provider Demographics
NPI:1871975094
Name:ALFONSO RIVERA, KRISIA E (MSW)
Entity type:Individual
Prefix:
First Name:KRISIA
Middle Name:E
Last Name:ALFONSO RIVERA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:AGUIRRE
Mailing Address - State:PR
Mailing Address - Zip Code:00704-0414
Mailing Address - Country:US
Mailing Address - Phone:787-671-8022
Mailing Address - Fax:
Practice Address - Street 1:PLAZA PORTOBELLO
Practice Address - Street 2:SUITE # 14
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-671-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR112391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical