Individual
ANTONIO A RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
4624 N 103RD AVE, PHOENIX, AZ 85037-5109
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-17551
AZ
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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