Individual
JENNIFER RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 W 189TH ST APT C, NEW YORK, NY 10040-4661
(646) 633-2416
Mailing address
501 W 189TH ST APT C, NEW YORK, NY 10040-4661
(646) 633-2416
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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