Individual
MRS. VIRGINIA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
1453 N MAIN STREET SUITE F, SAN LUIS, AZ 85349
(928) 627-6567
Mailing address
1440 W 16TH PL, YUMA, AZ 85364-5319
(928) 783-4278
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
822751
AHCCCS
AZ
Enumeration date
02/07/2007
Last updated
07/26/2007
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