MEDICARE: ARIANA RIVERO LMFT-ASSOCIATE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	204337	TX

General Provider Information

NPI Number	:	1144980343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANA RIVERO LMFT-ASSOCIATE

Provider Business Mailing Address
First Line	:	4210 SAIRMOUNT ST
Second Line	:	5080
City	:	DALLAS
State	:	TX
Zip	:	75219
Country	:	US
Telephone Number	:	575-704-9825
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 IRA E WOODS AVE STE 200
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-4096
Country	:	US
Telephone Number	:	817-722-6078
Fax Number	:	817-722-6077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2021
Last Update Date	:	12/29/2021

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