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Individual

DR. ANISSA RIVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD, HSPP

Contact information

Practice address
3903 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-2555
(219) 398-7050
(219) 392-6998
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1928
(219) 757-1950

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042306A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000611096
ANTHEM
IN
05
200934220
IN
Enumeration date
03/03/2007
Last updated
05/26/2011
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