| NPI | 1235784786 |
|---|---|
| Former Name | WESLEY ANN CRECELIUS RIVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: AK 127542) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |