Individual
THERESA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
18 MILA DR, MIDDLETOWN, NY 10940-3682
(646) 391-4919
Mailing address
18 MILA DR, MIDDLETOWN, NY 10940-3682
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001278
NY
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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