Most Relevant Information
Provider Data
| NPI Number: | 1003688771 |
| Provider Name: | JAY-LYNN RIVERA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-23-305915 |
Most Important Dates
| Enumeration Date: | 10/26/2023 |
| Last Updated: | 10/26/2023 |
Provider Practice Location
1084 LAKE MURRAY BLVD
IRMO
SC
290632821
Practice Location Phone/Fax
| Phone: | 7068425330 |
| Fax: | 7068425340 |
Provider Mailing Location
PO BOX 2567
AUGUSTA
GA
309032567
Provider Mailing Phone/Fax
| Phone: | 7068425330 |
| Fax: | 7068425340 |