Individual
DR. MICHELLE SUZANNE RIVERA HANBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX 76908-4901
(325) 654-3122
Mailing address
271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX 76908-4901
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
36131
TX
103TB0200X
Cognitive & Behavioral Psychologist
36131
TX
103TC0700X
Clinical Psychologist
36131
TX
103TC2200X
Clinical Child & Adolescent Psychologist
36131
TX
Other
Enumeration date
01/15/2013
Last updated
01/14/2019
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