Provider Demographics
NPI:1124914940
Name:RIVERS, ANNETTE LAURYN (PT, HEATH EDUCATION,)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:LAURYN
Last Name:RIVERS
Suffix:
Gender:F
Credentials:PT, HEATH EDUCATION,
Other - Prefix:
Other - First Name:LAURYN
Other - Middle Name:
Other - Last Name:RIVERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11710 PLAZA AMERICA DR STE 2000
Mailing Address - Street 2:PMB 217
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:888-720-7567
Mailing Address - Fax:
Practice Address - Street 1:11710 PLAZA AMERICA DR STE 2000
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-4743
Practice Address - Country:US
Practice Address - Phone:888-720-7567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist