Individual
ITZITL PACHECO RIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 SOUTH PKWY, CLIFTON, NJ 07014-1433
(201) 315-6036
Mailing address
120 SOUTH PKWY, CLIFTON, NJ 07014-1433
(201) 315-6036
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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