Doctor Name: | DR. KENYATTA O. RIVERS |
NPI Number: | 1205889912 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | SA3799 |
Business Practice Address: | 12424 Research Pkwy Suite 155 Orlando, FL - 328263249 |
Business Phone Number: | 4072494771 |
Business Fax Number: | 4072494774 |
Mailing Address: | 373 Briar Bay Cir, ORLANDO |
State: | FL |
Postal Code: | 328255964 |
Phone Number: | 4076582169 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA3799 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |