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General NPI Number Information
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NPI Number | 1558693432
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Entity Type | Individual
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Provider Name | DEBORA MARIE RIVERA L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 1115 DUPONT CIRCLE
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City | LOUISVILLE
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State | KY
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Zip | 40207-4020
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Country | US
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Telephone | 502-897-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1707 MILLGATE RD APT F
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City | LOUISVILLE
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State | KY
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Zip | 40223-1062
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Country | US
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Telephone | 502-599-5126
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 226300000X
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Taxonomy Name | Kinesiotherapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number |
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2320
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | KY
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