Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1073175170 |
---|---|
Provider Name | Lina Maria Rivera |
First Address | Altamonte Springs, FL 32714-3628 |
Second Address | Altamonte Springs, FL 32714-3628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2019 |
Last Update Date | 04/06/2021 |