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General NPI Number Information
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NPI Number | 1457912560
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Entity Type | Individual
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Provider Name | LAUREN E RIVERA BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 4100 N WICKHAM RD UNIT 107A-260
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City | MELBOURNE
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State | FL
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Zip | 32935-2485
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Country | US
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Telephone | 855-832-6727
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Fax | 772-675-9100
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Provider Business Mailing Address
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Address Line | 10850 S US HIGHWAY 1 STE 2
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-6407
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Country | US
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Telephone | 772-463-0444
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Fax | 722-219-1339
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-68062
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-43608
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-43608
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License Number State |
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