Individual
BONNIE J RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
301 N 2ND ST, ODESSA, MO 64076-1137
(816) 633-5921
(816) 633-7942
Mailing address
301 N 2ND ST, ODESSA, MO 64076-1137
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
002133
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498574607
—
MO
Enumeration date
01/10/2006
Last updated
01/17/2008
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