Individual
GRACE JOSEPHINE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
17-07 ROMAINE ST, FAIR LAWN, NJ 07410-2150
(201) 797-2660
(201) 797-5025
Mailing address
577 SCHAEFER AVE, ORADELL, NJ 07649-2517
(201) 261-1873
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
44SL06321500
NJ
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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