Provider Demographics
NPI:1427356922
Name:RIVERA, SAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAUL
Middle Name:
Last Name:RIVERA
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 1:413 JACOB DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-8516
Mailing Address - Country:US
Mailing Address - Phone:513-593-1181
Mailing Address - Fax:
Practice Address - Street 1:33 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1747
Practice Address - Country:US
Practice Address - Phone:513-593-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6308103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling