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General NPI Number Information
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NPI Number | 1588312649
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Entity Type | Organization
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Legal Business Name | RIVER RISE COUNSELING AND PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 9200 NW 39TH AVE STE 130-3185
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City | GAINESVILLE
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State | FL
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Zip | 32606-7331
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Country | US
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Telephone | 352-575-0055
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Fax |
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Provider Business Mailing Address
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Address Line | 3517 NW 52ND AVE
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City | GAINESVILLE
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State | FL
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Zip | 32605-1055
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Country | US
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Telephone | 352-870-4574
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JD WRIGHT
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Credential | PHD
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Telephone | 352-575-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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