Individual
MRS. FELICIA JACQUELINE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.S.W
Contact information
Practice address
1103 NATIONAL AVENUE, LAS VEGAS, NM 87701-8770
(505) 426-6462
Mailing address
PO BOX 2794, LAS VEGAS, NM 87701-2794
(505) 426-6462
(505) 212-0377
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
I-08306
NM
104100000X
Social Worker
M-07414
NM
1041C0700X
Clinical Social Worker
Primary
C-08306
NM
Other
Enumeration date
02/06/2012
Last updated
07/17/2018
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