| Doctor Name: | BRAULIO RIVERA |
| NPI Number: | 1356778989 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BA, CAC III |
| License Number: | ACC.0007003 |
| Business Practice Address: | 145 1st St Fort Lupton, CO - 806212002 |
| Business Phone Number: | 3038572723 |
| Business Fax Number: | |
| Mailing Address: | 1300 N 17th Ave, GREELEY |
| State: | CO |
| Postal Code: | 806319584 |
| Phone Number: | 9703472120 |
| Fax Number: | 9703003133 |
| NPI Enumeration Date: | 09/27/2013 |
| NPI Last Update Date: | 09/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | ACC.0007003 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |