Most Relevant Information
Provider Data
| NPI Number: | 1003684069 |
| Provider Name: | CHANTELL RIVERA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 37AC00590600 |
Most Important Dates
| Enumeration Date: | 12/19/2023 |
| Last Updated: | 12/19/2023 |
Provider Practice Location
300 CONSTITUTION AVE
BAYONNE
NJ
070025074
Practice Location Phone/Fax
| Phone: | 9173329377 |
| Fax: |
Provider Mailing Location
300 CONSTITUTION AVE
BAYONNE
NJ
070025074
Provider Mailing Phone/Fax
| Phone: | 9173329377 |
| Fax: |