Provider Demographics
NPI:1205201134
Name:RIVERA, MARIBEL
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
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 1:909 BLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-3055
Mailing Address - Country:US
Mailing Address - Phone:937-451-7700
Mailing Address - Fax:937-504-5093
Practice Address - Street 1:909 BLAINE AVE
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-3055
Practice Address - Country:US
Practice Address - Phone:937-451-7700
Practice Address - Fax:937-504-5093
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No253Z00000XAgenciesIn Home Supportive Care