Provider Demographics
NPI:1659956506
Name:RIVERA, NAYELI
Entity Type:Individual
Prefix:
First Name:NAYELI
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 1:2441B COUNTY ROAD 501
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-9677
Mailing Address - Country:US
Mailing Address - Phone:662-837-8154
Mailing Address - Fax:
Practice Address - Street 1:2441B COUNTY ROAD 501
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-9677
Practice Address - Country:US
Practice Address - Phone:662-837-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health