| NPI | 1053712711 |
|---|---|
| Former Name | VIVIAN ILENE RIVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60587450) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO 60457984) |
| 101YM0800X Counselor, Mental Health (Licence: KY 275012) | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2023-06-12 |