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Individual

DEBORA MARIE RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
1115 DUPONT CIRCLE, LOUISVILLE, KY 40207-4020
(502) 897-2400
Mailing address
1707 MILLGATE RD, APT F, LOUISVILLE, KY 40223-1062
(502) 599-5126

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
172V00000X
Community Health Worker
174H00000X
Health Educator
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
KY
225700000X
Massage Therapist
Primary
2320
KY
225800000X
Recreation Therapist
226300000X
Kinesiotherapist
390200000X
Student in an Organized Health Care Education/Training Program
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
210614
AMTA
KY
01
549723-07
NCBTMB
Enumeration date
02/03/2010
Last updated
03/23/2010
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