Provider Demographics
NPI:1235470493
Name:RIVERS, MICHAL SHVARTZ (BCBA)
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:SHVARTZ
Last Name:RIVERS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 ENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-3715
Mailing Address - Country:US
Mailing Address - Phone:512-900-1425
Mailing Address - Fax:
Practice Address - Street 1:2517 ENFIELD RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-3715
Practice Address - Country:US
Practice Address - Phone:512-900-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
11-31-2980OtherBCBA