Provider Demographics
NPI:1447824693
Name:RIVERA, ANISSYA (BCBA)
Entity type:Individual
Prefix:
First Name:ANISSYA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 INTERNATIONAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5028
Mailing Address - Country:US
Mailing Address - Phone:407-915-7729
Mailing Address - Fax:407-588-6294
Practice Address - Street 1:2100 N ALAFAYA TRL STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4748
Practice Address - Country:US
Practice Address - Phone:407-720-4101
Practice Address - Fax:407-603-0012
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL1-24-72963103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst