Provider Demographics
NPI:1750102851
Name:RIVERA, SOPHIA NATASHA (RBT)
Entity type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:NATASHA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12305 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3050
Mailing Address - Country:US
Mailing Address - Phone:786-405-7305
Mailing Address - Fax:
Practice Address - Street 1:12305 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3050
Practice Address - Country:US
Practice Address - Phone:786-405-7305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician