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General NPI Number Information
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NPI Number | 1962928572
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Entity Type | Organization
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Legal Business Name | FELIPE RIVERA OCCUPATIONAL THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 13 PERALTA RD
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City | PERALTA
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State | NM
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Zip | 87042-8856
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Country | US
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Telephone | 505-249-8226
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Fax | 505-213-8559
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Provider Business Mailing Address
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Address Line | 13 PERALTA RD
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City | PERALTA
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State | NM
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Zip | 87042-8856
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Country | US
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Telephone | 505-249-8226
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Fax | 505-213-8559
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MR. FELIPE FERMIN RIVERA
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Credential | MOT/L
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Telephone | 505-249-8226
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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 | 2182
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License Number State | NM
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