Individual
LISA DANIELLE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
2693 W 530 N, PROVO, UT 84601-5890
(801) 885-2683
Mailing address
2693 W 530 N, PROVO, UT 84601-5890
(801) 885-2683
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
13462193-4901
UT
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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