Provider Demographics
NPI:1629735204
Name:RIVERO, KAYLIN MICHELLE
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:MICHELLE
Last Name:RIVERO
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 1:15411 SW 77TH CIRCLE LN APT 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1823
Mailing Address - Country:US
Mailing Address - Phone:786-317-8913
Mailing Address - Fax:
Practice Address - Street 1:9415 SW 72ND ST STE 131
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5492
Practice Address - Country:US
Practice Address - Phone:305-662-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst