Individual
THERESA RENEE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NMT
Contact information
Practice address
643 CHALAN SAN ANTONIO STE 108, TAMUNING, GU 96913-3644
(671) 687-8079
Mailing address
155 W SANTA BARBARA AVE, DEDEDO, GU 96929-5304
(671) 687-8079
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0024273
CO
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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