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General NPI Number Information
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NPI Number | 1598882755
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Entity Type | Individual
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Provider Name | ANNA MARIA RIVERA O.T.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 714 CALLE DON DIEGO
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City | ESPANOLA
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State | NM
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Zip | 87532-3414
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Country | US
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Telephone | 505-367-3362
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 194
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City | JEMEZ SPRINGS
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State | NM
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Zip | 87025-0194
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Country | US
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Telephone | 505-829-3430
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1290
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License Number State | NM
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