Provider Demographics
NPI:1710264932
Name:RIVERA ORLANDO, TAMARA (BS)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:RIVERA ORLANDO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 CHIPPEWA TRL
Mailing Address - Street 2:
Mailing Address - City:ALBRIGHTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18210-7770
Mailing Address - Country:US
Mailing Address - Phone:570-643-5494
Mailing Address - Fax:
Practice Address - Street 1:724 PHILLIPS ST STE A
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2242
Practice Address - Country:US
Practice Address - Phone:570-517-0892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)