Individual
MR. GUADALUPE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
810 CLASSON AVE, BROOKLYN, NY 11238
(718) 230-5100
Mailing address
60 KINGSLAND AVE #3B, BROOKLYN, NY 11211
(347) 671-1570
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24182
NY
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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