Provider Demographics
NPI:1225867112
Name:RIVERS, DAWN MARIE (LMT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7858 E KEIM DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-4766
Mailing Address - Country:US
Mailing Address - Phone:480-209-3416
Mailing Address - Fax:
Practice Address - Street 1:7858 E KEIM DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-4766
Practice Address - Country:US
Practice Address - Phone:480-209-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-01884P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist