Provider Demographics
NPI:1245965748
Name:RIVERA, KARLA
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REGAN
Other - Middle Name:KARLA
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:INTERN (LMHC)
Mailing Address - Street 1:2701 W PICACHO AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-4732
Mailing Address - Country:US
Mailing Address - Phone:575-652-3646
Mailing Address - Fax:575-255-1625
Practice Address - Street 1:2701 W PICACHO AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-4732
Practice Address - Country:US
Practice Address - Phone:575-652-3646
Practice Address - Fax:575-255-1625
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health