Provider Demographics
NPI:1740683960
Name:RIVERS, CHRISTINA LYDIA
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYDIA
Last Name:RIVERS
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 1:85 LAY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-3623
Mailing Address - Country:US
Mailing Address - Phone:856-422-0932
Mailing Address - Fax:
Practice Address - Street 1:85 LAY DR
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-3623
Practice Address - Country:US
Practice Address - Phone:856-422-0932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health