Individual
ILKA ANNETTE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
285 CENTRAL ST STE 201, LEOMINSTER, MA 01453-6144
(617) 749-8831
Mailing address
285 CENTRAL ST STE 201, LEOMINSTER, MA 01453-6144
(617) 749-8831
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-30046
MA
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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