Individual
JENNIFER REGENIA RIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11614 AMARA PL, LAKE RIDGE, VA 22192-7414
(571) 438-1943
Mailing address
11614 AMARA PL, LAKE RIDGE, VA 22192-7414
(571) 438-1943
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003755
VA
101YP2500X
Professional Counselor
PRC14302
DC
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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