Individual
MRS. SUSAN RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 CARPENTERS WAY, LAKELAND, FL 33809-3926
(863) 458-2029
Mailing address
1917 CASCO ST., LAKELAND, FL 33801
(863) 458-2029
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4684
FL
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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