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NPI Code Detail

MEDICARE: ALEXANDRA EMMA RILEY

MEDICARE: ALEXANDRA EMMA RILEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3106S00000XBehavior Technician
4104100000XSocial Worker10329-MNV

General Provider Information

NPI Number : 1063987436
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA EMMA RILEY
Provider Business Mailing Address
First Line : 4545 PLANO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-5189
Country : US
Telephone Number : 781-492-3502
Fax Number :
Provider Business Practice Location Address
First Line : 4545 PLANO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-5189
Country : US
Telephone Number : 781-492-3502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2018
Last Update Date : 02/01/2023

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Directions to “ ALEXANDRA EMMA RILEY ” Practice Location

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