| NPI | 1639341704 |
|---|---|
| Former Name | JODY MARIE RIVERA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CO OT.0001605) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CO 1010497) |
| Enumeration Date | 2008-03-29 |
| Last Update Date | 2024-04-25 |