Individual
IVANA RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
381 4TH AVENUE, BETHEL, AK 99559
(907) 543-2242
Mailing address
PO BOX 3227, BETHEL, AK 99559-3227
(907) 543-2242
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
10/17/2017
Last updated
08/31/2020
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