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Individual
DR. VINCENT BRYAN RIVER
Active
Individual
DR. VINCENT BRYAN RIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
328
MT
103TF0200X
Forensic Psychologist
328
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490739
—
MT
01
—
51871
BLUE CROSS BLUE SHIELD
MT
01
—
7718 59860 0000
TRICARE
MT
Enumeration date
11/28/2006
Last updated
10/31/2012
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