Individual
LAURA P RIVERA-R
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
172 ELLISON AVE, ROOSEVELT, NY 11575-2173
(516) 813-8363
Mailing address
172 ELLISON AVE, ROOSEVELT, NY 11575-2173
(516) 813-8363
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
000
NY
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
000
NY
Other
Enumeration date
01/25/2022
Last updated
01/26/2022
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