Individual
MATTHEW MARCUS RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMR
Contact information
Practice address
2363 CALLE DEL SUR, MESILLA, NM 88463
(575) 527-2566
Mailing address
2363 CALLE DEL SUR, MESILLA, NM 88463
(575) 527-2566
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
247200000X
Other Technician
509424993
NM
Other
Enumeration date
06/13/2017
Last updated
07/21/2022
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