Healthcare Provider Details

I. General information

NPI: 1801653860
Provider Name (Legal Business Name): ALEANA C RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 LAKE CREST CIR
COOKEVILLE TN
38506-5943
US

IV. Provider business mailing address

1521 LAKE CREST CIR
COOKEVILLE TN
38506-5943
US

V. Phone/Fax

Practice location:
  • Phone: 931-280-1044
  • Fax:
Mailing address:
  • Phone: 931-280-1044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2358
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: