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General NPI Number Information
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NPI Number | 1518772607
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Entity Type | Individual
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Provider Name | ROSA MARILI RIVERA
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Gender | Female
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 975 MERRIAM AVE STE 210
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City | LEOMINSTER
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State | MA
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Zip | 01453-1240
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Country | US
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Telephone | 888-763-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 1234 HYDE PARK AVE STE 202
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City | HYDE PARK
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State | MA
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Zip | 02136-2819
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Country | US
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Telephone | 888-763-7272
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Fax | 877-243-2959
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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 |
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License Number State | MA
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