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General NPI Number Information
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NPI Number | 1285389338
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Entity Type | Individual
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Provider Name | NICOLE MARIE RIVERO
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Gender | Female
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 5400 S UNIVERSITY DR STE 502
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City | DAVIE
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State | FL
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Zip | 33328-5313
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Country | US
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Telephone | 888-754-0398
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 W 4TH CT
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City | HIALEAH
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State | FL
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Zip | 33010-1424
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Country | US
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Telephone | 786-656-7909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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