Individual
MISS RAQUEL RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2850 NORTH 24 STREET, PHOENIX, AZ 85008
(602) 266-5976
Mailing address
13379 WEST MAUNA LOA LANE, SURPRISE, AZ 85379
(623) 546-6820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP4277
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
856205
AHCCCS
AZ
Enumeration date
02/05/2007
Last updated
07/08/2007
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