Individual
CARLOS RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3113 E WASHINGTON AVE, MADISON, WI 53704-4330
(608) 416-5777
Mailing address
4972 CHRISTY CIR, ROCKFORD, IL 61114-7356
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20237-130
WI
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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