Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC10596 | MD |
NPI | 1003427386 |
---|---|
Provider Name | Ana Patricia Rivera |
First Address | Olney, MD 20832-2077 |
Second Address | Greenbelt, MD 20770-2024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2020 |
Last Update Date | 11/08/2020 |