Most Relevant Information
Provider Data
| NPI Number: | 1003323874 |
| Provider Name: | ERIN WALLEY RIVERA LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 14460 |
Most Important Dates
| Enumeration Date: | 01/03/2018 |
| Last Updated: | 01/03/2018 |
Provider Practice Location
5245 N SOCRUM LOOP RD
LAKELAND
FL
338094253
Practice Location Phone/Fax
| Phone: | 8638591446 |
| Fax: |
Provider Mailing Location
1117 LADY ELAINE DR
VALRICO
FL
335945821
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |