Individual
MIKENZI RIVENBARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 PORTERS NECK RD, WILMINGTON, NC 28411-9196
(910) 686-7195
Mailing address
111 WHIPPORWILL LN, WILMINGTON, NC 28409-3559
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15400
NC
Other
Enumeration date
01/02/2019
Last updated
02/27/2025
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