Individual
MAYRA RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11240 WAPLES MILL RD, FAIRFAX, VA 22030-6078
(703) 237-2219
Mailing address
3330 WOODBURN VILLAGE DR APT T2, ANNANDALE, VA 22003-6869
(571) 274-4215
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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