Individual
TASHIA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-8404
Mailing address
1123 HOLIDAY DR, SOMONAUK, IL 60552-9647
(815) 474-7339
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006774
IL
Other
Enumeration date
06/08/2022
Last updated
07/22/2022
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