Provider Demographics
NPI:1962779843
Name:RIVERS, SANDRA BROWN
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:BROWN
Last Name:RIVERS
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 1:2780 NORTHESAT 14TH STREET SUITE 5
Mailing Address - Street 2:BUTTERFLY EFFECT
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:843-263-8555
Mailing Address - Fax:
Practice Address - Street 1:2780 NORTHESAT 14TH STREET SUITE 5
Practice Address - Street 2:BUTTERFLY EFFECT
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062
Practice Address - Country:US
Practice Address - Phone:843-263-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist