Individual
GUILLERMO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 CLAIRE LN, DAVENPORT, FL 33837-3207
(407) 989-3834
Mailing address
130 CLAIRE LN, DAVENPORT, FL 33837-3207
(407) 989-3834
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
FL
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM102678
FL
Other
Enumeration date
05/31/2016
Last updated
02/15/2022
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