Nicole Marie Rivas | San Antonio, TX • PECOS Search

Nicole Marie Rivas

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

225 E Sonterra Blvd Ste 120, San Antonio, TX 78258-3993

(210) 495-9944 (956) 784-5620

PECOS Enrollment

Based on the most recent information from CMS, provider Nicole Marie Rivas does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1124752795
Provider Type
Individual
Full Name
Rivas, Nicole Marie
Title
Miss
Credential
M.S., CCC-SLP

Gender
Female
Sole Proprietor
No
Enumeration Date
7/11/2022
Last Updated
7/11/2022

Contact Information

Practice Location

225 E Sonterra Blvd Ste 120, San Antonio, TX 78258-3993

(210) 495-2540

Mailing Location

10102 Ingram Rd Apt 2306, San Antonio, TX 78245-1030

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License Unlisted Issuer