Individual
JACQUELINE RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2113 CASSIA CIR APT C, KISSIMMEE, FL 34741-2876
(407) 361-1539
Mailing address
2113 CASSIA CIR APT C, KISSIMMEE, FL 34741-2876
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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