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General NPI Number Information
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NPI Number | 1740950484
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Entity Type | Individual
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Provider Name | ZULMA ALEXANDRA RIVERA
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Gender | Female
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 15721 N GREENWAY HAYDEN LOOP STE 103
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1776
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Country | US
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Telephone | 602-362-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 3514 W MALAPAI DR
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City | PHOENIX
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State | AZ
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Zip | 85051-1228
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Country | US
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Telephone | 623-230-9077
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | D08868340
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License Number State | AZ
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