Healthcare Provider Details

I. General information

NPI: 1487582151
Provider Name (Legal Business Name): HALEY RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 JEFFERSON AVE
MIDLAND MI
48640-4528
US

IV. Provider business mailing address

2719 JEFFERSON AVE
MIDLAND MI
48640-4528
US

V. Phone/Fax

Practice location:
  • Phone: 989-315-4414
  • Fax: 989-393-5974
Mailing address:
  • Phone: 989-315-4414
  • Fax: 989-393-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: