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General NPI Number Information
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NPI Number | 1720365513
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Entity Type | Individual
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Provider Name | JENNY REBECCA RIVERA LBSW
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Gender | Female
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 2629 GRANADA
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City | WESLACO
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State | TX
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Zip | 78596-4540
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Country | US
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Telephone | 956-345-6201
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Fax | 956-969-8704
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Provider Business Mailing Address
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Address Line | 2629 GRANADA
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City | WESLACO
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State | TX
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Zip | 78596-4540
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Country | US
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Telephone | 956-345-6201
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Fax | 956-969-8704
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 37815
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License Number State | TX
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