Individual
TARA MARIE YSABEL RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9031 W LA MADRE WAY, LAS VEGAS, NV 89149-3536
(702) 417-4753
Mailing address
1811 NAVARRE LN, HENDERSON, NV 89014-5101
(702) 856-9673
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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