Individual
MICHELLE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
403 W MEQUON RD, MEQUON, WI 53092-3514
(262) 643-4771
Mailing address
403 W MEQUON RD, MEQUON, WI 53092-3514
(262) 643-4771
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3397-154
WI
Other
Enumeration date
12/13/2006
Last updated
03/14/2013
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