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NPI 1477210912

NPI 1477210912 : JORDAN KAY RIVERO BCBA : LUBBOCK, TX

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General NPI Number Information
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    NPI Number           |    1477210912
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    Entity Type          |    Individual 
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    Provider Name        |    JORDAN KAY RIVERO BCBA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/18/2021
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    Last Update Date     |    07/07/2025
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Provider Practice Location Address
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    Address Line         |    6102 82ND ST STE 10 
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    City                 |    LUBBOCK
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    State                |    TX
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    Zip                  |    79424-0802
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    Country              |    US
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    Telephone            |    806-933-3333
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1600 NE LOOP 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78209
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    Country              |    US
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    Telephone            |    
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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       |    6038
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    License Number State |    TX
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