Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 073391 | NY |
NPI | 1003024621 |
---|---|
Provider Name | Priscilla Rivera |
First Address | Tarrytown, NY 10591-5152 |
Second Address | Yonkers, NY 10701-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 20/05/2020 |