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1487015707
SHANE RIVERA
COMMERCE, CA
NPI
1487015707
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-03-14
Last Update Date
2016-03-14
Business Address
-- SHANE RIVERA
5053 ASTOR AVE
COMMERCE, CA 90040-1301
Phone number: 323-722-4529
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Mailing Address
-- SHANE RIVERA
5053 ASTOR AVE
COMMERCE, CA 90040-1301
Phone number:
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