Provider Demographics
NPI:1457663916
Name:RIVERA, DEANNA FRANCES (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:FRANCES
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1009
Mailing Address - Country:US
Mailing Address - Phone:716-874-2881
Mailing Address - Fax:
Practice Address - Street 1:453 LEROY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-2144
Practice Address - Country:US
Practice Address - Phone:716-816-3519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015326235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist