Individual
MR. ROBERTO RIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Contact information
Practice address
235 E. PONCE DE LEON, SUITE 120, DECATUR, GA 30030
(770) 962-7508
(678) 985-4296
Mailing address
235 E PONCE DE LEON AVE, SUITE 120, DECATUR, GA 30030-3452
(770) 962-7508
(678) 985-4296
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC004905
GA
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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