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Individual

SANDRA D RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC IT

Contact information

Practice address
130 E WALNUT ST, SUITE 706, GREEN BAY, WI 54301-4239
(920) 437-8256
(920) 437-1188
Mailing address
130 E WALNUT ST, SUITE 706, GREEN BAY, WI 54301-4239

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3423-226
WI

Other

Enumeration date
09/27/2016
Last updated
09/27/2016
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