Kenneth Elijah Rivera Jr.
Behavior Technician in Stuart, FL. Individual provider (NPI-1).
NPI number1982198628
StatusActive
Last updated in NPPESJun 17, 2018
Details
- NPI
- 1982198628
- Entity type
- Individual (NPI-1)
- Name
- Kenneth Elijah Rivera Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 17, 2018
- Last updated
- Jun 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
9150 Sw 21st DrStuart, FL 34997-7925
Phone 772-222-5560 · Fax 844-652-8088
Mailing address
1001 Park Hill DrHaverhill, FL 33417-5700
Phone 561-502-5310
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