Individual
MAYRA MADELY RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
750 EAST AVE, PAWTUCKET, RI 02860-6245
(401) 640-0925
Mailing address
90 CLAY ST APT 11, CENTRAL FALLS, RI 02863-3039
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT02236
RI
Other
Enumeration date
08/11/2019
Last updated
08/11/2019
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