Individual
TYLER RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
(631) 385-7795
Mailing address
14427 227TH ST, LAURELTON, NY 11413-3541
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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