Individual
JOHANNISS M DE LEON RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DCC
Contact information
Practice address
2800 WADEVIEW LOOP, SAINT CLOUD, FL 34769-6534
(407) 480-8743
Mailing address
2800 WADEVIEW LOOP, SAINT CLOUD, FL 34769-6534
(407) 480-8743
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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