Individual
AMANDA LEIGH RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3202 MALLARD LN, GRETNA, LA 70056-7795
(916) 397-4045
(504) 814-4472
Mailing address
PO BOX 1600, HARVEY, LA 70059-1600
(504) 517-2894
(504) 814-4472
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
406
LA
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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