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Individual
LUCELLY M. MEDEIROS RIVERA
Active
Individual
LUCELLY M. MEDEIROS RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61139749
WA
101Y00000X
Counselor
—
WA
101YM0800X
Mental Health Counselor
—
WA
106S00000X
Behavior Technician
RBT-15-09036
WA
Other
Enumeration date
10/10/2018
Last updated
03/04/2021
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