Provider Demographics
NPI:1194576595
Name:RIVERA, ALLEY MARIA
Entity type:Individual
Prefix:
First Name:ALLEY
Middle Name:MARIA
Last Name:RIVERA
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 1:305 1/2 ASH AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-4074
Mailing Address - Country:US
Mailing Address - Phone:681-331-8052
Mailing Address - Fax:
Practice Address - Street 1:305 1/2 ASH AVE
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-4074
Practice Address - Country:US
Practice Address - Phone:681-331-8052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant