Provider Demographics
NPI:1093052730
Name:RIVERA, DIANA ESTHER
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:ESTHER
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 EAST ST
Mailing Address - Street 2:106
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5468
Mailing Address - Country:US
Mailing Address - Phone:339-223-1337
Mailing Address - Fax:
Practice Address - Street 1:730 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5924
Practice Address - Country:US
Practice Address - Phone:339-223-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health