Provider Demographics
NPI:1225221609
Name:RIBERA, JOHN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:RIBERA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 OLD MAIN HILL
Mailing Address - Street 2:DEPT. OF COMMUNICATIVE DISORDERS AND DEAF EDUCATION
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84322-1000
Mailing Address - Country:US
Mailing Address - Phone:435-707-7190
Mailing Address - Fax:435-797-0221
Practice Address - Street 1:DEPT OF COMMUNICATIVE DISORDERS AND DEAF EDUCATION
Practice Address - Street 2:1000 OLD MAIN HILL
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84322-1000
Practice Address - Country:US
Practice Address - Phone:435-707-7190
Practice Address - Fax:435-797-0221
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT106502-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist